Single payer debate no so easy

[Slavister]

Well.. first.. I don't do that... so screw you for saying that I do.. you should stop lying.

Bingo.. which is why in some states.. and or facilities we DON"T accept Medicaid patients.

Uh... You just confirmed that YOU do accept Medicaid patients. By saying you don't accept them in SOME states, you are confirming you are accepting them in OTHER states. And you had also said they were UNDER cost for you (unless you overutilize and run unnecessary tests)!

My apologies if I missed something...

 

[Slavister]

... OR pushing the govt to reimburse PROPERLY for them.

Well.... you are talking that same government that you plan on REDUCING REIMBURSEMENTS FOR EVERY PROVIDER.

You realize your tremendous intellectual disconnect don't you?

Hehe. Nice try. You are trying to create "disconnects" where there are none. That was a good attempt too!

1. When I said "reimburse properly" it means ABOVE COST. So that providers can still make a profit, let alone decent living... (AND without having to use people as guinea pigs).

2. When we talk about reducing reimbursements, while most of that will not affect providers but instead will affect insurance companies and low-level staff (like billing, and other admin), it will indeed reduce provider income by NOT a huge extent. (You call $40k yearly reduction on $200k+ income huge, I understand. I don't; and again, even in Canada, average physician makes $260k)

You see? The former says we should pay enough to make a profit (and a good one at that). The latter says the profit should be so LARGE as to run our system into the ground. Makes sense now?

 

[Slavister]

If you want to get the savings you claim your going to get.. then yes. The major difference in cost between other countries.. and ours is our wages and labor are so much higher. Whats really frustrating having this conversation with single payer advocates.. is that when it suits your purpose.. you love to compare the US to other countries.. "look they do it cheaper with single payer".

But.. you IGNORE any comparison with other countries in HOW they achieve this for example by paying their providers.. much less..

Suddenly its "well well we don't have to do it that way".. so magically savings is going to come from some other area.. oh .. the administration fairie.

And again you compare other countries with us : "look.. they do it cheaper and they cover EVERYBODY with their government healthcare"..

BUT you want to ignore the comparison of what they pay for in their government payer.. and what we pay for here. Suddenly.. you don't want to hear that they government system doesn't cover everyone for PT.. or home health.. etc.

Suddenly.. you ignore those facts.. and its "well well" we don't have to do it their way we can do medicare for all".. which again.. means you are not going to get the savings you claim you are going to get.

Over and over.. single payer advocates are dishonest in the discussion., When it suits your purpose.. you compare the US and other countries.. when it doesn't.. you ignore that comparison.

Other countries with single payer DO score less than us in a number of care areas.. notable effective care... but you don't want to face that fact.. and then its back.. "to well they cost less".. sure.. but then you are back to ignoring WHY they cost less..

And you keep telling the big lie.. that you can reduce healthcare spending by half in this country.. while demand is INCREASING.. with no negative effect on quality and access of care.

We've written up 10 pages already on this. I doubt we'll change each other's mind much, and I doubt anyone is going to read these 10 pages. So it's time to make closing arguments IMO.

What you said above sounds like a good closing argument. (Of course you are welcome to make another one if you like.)

Here is mine:

1. Problem: Today's system is NOT sustainable. Not only because we don't cover everyone. But also because those that we DO cover pay more and more for their healthcare. More and more people go bankrupt due to inability to pay. More and more people (and their families) have to CARE about payments when they are ill. More and more people spend higher percentage of their budgets on medical needs. AND our current government costs to pay for the medical services is running up an unmanageable debt, which if continued, would result in potential bankruptcy.

2. Many other countries in the world do NOT have this issue. Why not mimic some of what they do to improve this situation?

3. We can start by going to Single Payer system and eliminating a lot of overheads I discussed already: admin costs (that are LARGE according to links I already posted, and despite your statements (but no links) to the contrary), insurance companies profits, insurance companies costs for infrastructure, extra staff needed at all doctor offices for dealing with multiple payers.

4. I accept that Govt can screw up the system and if dealing with Medicare system is much more complex than dealing with more efficient private insurances (which by the way means that private insurances still incur the costs of dealing with medicare at their back end), we may have to change this as well. Clearly it's possible, simply because other countries do this. IF (and I don't know if this "if" is true or not, despite your claims but no proof) dealing with Medicare system is hard, we DO need to improve it, even if means copying what others do.

5. How is Single Payer paid for?
- same healthcare costs that companies + employees already incur today, redirected toward single payer
- savings from reductions in admin costs and admin staff reductions
- reduction in income made by healthcare professionals (say to Canadian level? which today is ~$260k/year average)
- large reduction in drug costs / reimbursements to pharma
- (perhaps realigning payments to avoid giving incentives for over-treatments? and improving preventative care)
- IF ABOVE IS NOT ENOUGH, increase in federal tax rates (in progressive or regressive fashion - to be decided and while important, is secondary to this discussion IMO)

6. IF ABOVE is still financially not sustainable, start reducing services to the level of other countries. Clearly some provide just AS GOOD of healthcare as USA does today.

It's time to STOP being the WORST country in terms of healthcare per dollar we spend. By that measure, we are LEAST efficient of ALL countries; and they all use some form of Single Payer. If that does not tell us much, I don't know what will.

 

[Boo Radley]

Yes... and HONEST look.

so how about you address and refute all the points that Greenbeard has made on his original post?

Well, we can do them one by one. Which one would you like to start with?

 

[Boo Radley]

Once again, individuals, particularly people who pay tax will be paying those premiums THROUGH THEIR TAXES and also be paying the premiums of families of those that don't pay tax. The cost of bandaids in hospitals isn't high insurance premiums, or because they treat people unable to pay by the way. Our current tax system is taking in almost a trillion less that what it's paying out. Where do you think the money is going to come from to take on another $1.5-2.5 TRILLION to fund M4A? NO, it's not because we won't be paying premiums - that's private money you've earned NOT government revenue.

Again yes, hence a push. No loss. What is loss is made up by not paying it elsewhere, plus the ability for the employer to pay more.

And to further lower costs, which would lower premiums, bandaids would cost pennies and not dollars.

 

[Boo Radley]

Single payer systems cost more, deliver less, cause people to suffer (and die) in long waiting lists.

If you have a cold it might be good, but if you have serious problems... it’s seriously ****ed.

Read Code Blue... written by someone who worked in a single payer system.

That's factually inaccurate.

 

[Bullseye]

Again yes, hence a push. No loss. What is loss is made up by not paying it elsewhere, plus the ability for the employer to pay more.

And to further lower costs, which would lower premiums, bandaids would cost pennies and not dollars.

Sorry, no. You assume what your employer and you pay for group insurance will directly translate to the cost of single payer. Not even liberal think tanks say that.

 

[jaeger19]

Turning away Medicaid patients because that's the ONLY patients remaining? The pool of non-Medicaid patients is FAR FAR LARGER than the pool of Medicaid patients. If you accepted just 1 insurance, you'd REALLY be limiting yourself, so clearly noone wants to do that.

But no, you are saying companies are so desperate that they HAVE to tap into the relatively small pool of Medicaid patients that are UNDER COST for them to provide them services, which they then overutilize and use people as human guinea pigs just to turn a bit of a profit after all on them...

Ok that makes sense...

What are babbling about now? you claimed that doctors would only accept the "best paying patients".. but I point out that they accept all sorts of other patients even though there is different pay scales...

So. if they don't accept Medicaid.. which we know happens.. its not because" there is better insurances".. its because there is no profit for them to be had.

But no, you are saying companies are so desperate that they HAVE to tap into the relatively small pool of Medicaid patients that are UNDER COST for them to provide them services, which they then overutilize and use people as human guinea pigs just to turn a bit of a profit after all on them...

Again... stop babbling.

No.. these companies are not "so desperate that the HAVE to anything". These companies in general are so large.. that they can not only make profit on all the other insurances.. BUT they can ALSO make profit on the Medicaid patient... particularly if they overutilize services...

And of course as I said.. some companies use them as filler.. or they do it on a limited basis to keep the referral sources happy.

you need to stop making stuff up and do a bit of reading comprehension.

 

[jaeger19]

Well, we can do them one by one. Which one would you like to start with?

Pick one and we will go from there.

 

[jaeger19]

Hehe. Nice try. You are trying to create "disconnects" where there are none. That was a good attempt too!

1. When I said "reimburse properly" it means ABOVE COST. So that providers can still make a profit, let alone decent living... (AND without having to use people as guinea pigs).

2.?

Except you think you are going to get go above cost.. BUT still get a savings of 8% of GDP. While demand for services is going up.. That's why its a disconnect. Medicaid and Medicare are already the lowest payers.. and in some instances are below cost.. ALREADY.

In fact.. medicare/Medicaid reimbursements have been lowered and controlled since 1998. (except for pharmacy). but there has been numerous things that have been done to lower provider reimbursement... to the point its ALREADY close to or below cost.

When we talk about reducing reimbursements, while most of that will not affect providers but instead will affect insurance companies and low-level staff (like billing, and other admin), it will indeed reduce provider income by NOT a huge extent. (You call $40k yearly reduction on $200k+ income huge, I understand. I don't; and again, even in Canada, average physician makes $260k)

And that's complete and utter BS. You are claiming that you want to reduce our GDP by 8%.. basically decrease healthcare spending by 1/2 or more.. and yet.. you think that's "mostly going to come from administration savings"... Please.. that's simply absurd.

how much of GDP do you think is adminsttration costs? You think its 6% of GDP?

You see? The former says we should pay enough to make a profit (and a good one at that).

Which is a lie if you want to get the savings you think you are getting.

 

[jaeger19]

1. Problem: Today's system is NOT sustainable. Not only because we don't cover everyone. But also because those that we DO cover pay more and more for their healthcare..

Factually wrong.. people for healthcare insurance.. not healthcare for the most part. Actual expenditure on healthcare has been relatively controlled versus the increase in demand.

https://wire.ama-assn.org/ama-news/growth-health-spending-slows-post-aca-era

.

More and more people go bankrupt due to inability to pay

Factually incorrect:

https://www.fraserinstitute.org/article/medical-bankruptcy-myth

More and more people spend higher percentage of their budgets on medical needs

Factually incorrect:

Out-of-pocket spending share has been on a steady decline for 50 years

https://wire.ama-assn.org/ama-news/growth-health-spending-slows-post-aca-era

Many other countries in the world do NOT have this issue. Why not mimic some of what they do to improve this situation?

and actually we don't have this issue either.. see above.. EXCEPT for the fact we don't cover everyone.

But.. why not mimic some of what they do? fine.. BUT lets be honest is WHAT THEY DO.. and some of that means greater wait times.. some of that means less choice in providers.. some of that means that insurance is LESS coverage than what americans get now.
Some of what they do is limit choice of physicians or specialists. Some of what they do means they shift costs.. so there really isn;t that much savings. Some of what they do will decrease our GDP by a ton and hurt our economy.

Be honest in what you say you want to do. You aren;t being honest.. you say.." oh well.. providers will get a little less"... pooh,, not if you want to get the saving you keep telling everyone we are going to get. And you don't want to tell people the truth that it IS going to hit the economy hard.. and 8% decline in healthcare.. which would get us to the level of GDP that other countries pay.. means a decline of TWICE what GDP declined in the Great Recession. But you want to gloss over that.

We can start by going to Single Payer system and eliminating a lot of overheads I discussed already: admin costs (that are LARGE according to links I already posted, and despite your statements (but no links) to the contrary

) IF the single payer system doesn;t actually put more administration costs into the mix.. and guess what? Two of the worst insurances for administration costs for providers are VA and Medicaid. Government programs... so.. while you think the administration fairie is going to wave their magic wand.. providers that actually do medical billing know better. And the admin costs.. are large.. but no where near the size of labor and wages for providers and support staff... AND those admin costs? They are due to salaries and wages to do claims.. the cost is NOT all because of multiple insurances.

insurance companies profits, insurance companies costs for infrastructure,

Sure.. the pipe dream that you are going to get the private insurance companies out of the profit making business.. .but.. wait.. you seem to forget that insurance companies profits? One of their largest profits.. is in administering PUBLIC HEALTHCARE LIKE MEDICARE. But hey.. you think you are going to wave again the magic wand and get insurance company industry to roll over and quit.

extra staff needed at all doctor offices for dealing with multiple payers.

Which is minor.. and that is logical. what costs more a facility with 1000 claims... or 20 claims from 20 providers.. sorry but its the time spent for many more claims. Having multiple insurances has a cost.. but its minor compared to the other administration issues.. particularly when there is outlier insurances that have more hoops.. (like Medicaid).

4. I accept that Govt can screw up the system and if dealing with Medicare system is much more complex than dealing with more efficient private insurances (which by the way means that private insurances still incur the costs of dealing with medicare at their back end), we may have to change this as well. Clearly it's possible, simply because other countries do this

Not really they don't.. in some cases they get efficiency.. in some cases they don't gain much... The big way they get cost reduction is because of reduced payments to providers.

 

[jaeger19]

How is Single Payer paid for?
- same healthcare costs that companies + employees already incur today, redirected toward single payer

I see.. so in other words.. no savings at ALL! Well at least you are honest.. about that.. so everyone is going to be paying the same as before. hmmm..

savings from reductions in admin costs and admin staff reductions

Interesting.. so employees and companies are going to pay more.. and we are going to have decreased wages and jobs in the economy.

reduction in income made by healthcare professionals (say to Canadian level? which today is ~$260k/year average)

So again.. we all pay the same into single payer.. but there will be fewer providers, and less wages in the economy.

large reduction in drug costs / reimbursements to pharma

So less wages and jobs in the economy.

IF ABOVE IS NOT ENOUGH, increase in federal tax rates (in progressive or regressive fashion - to be decided and while important, is secondary to this discussion IMO)

Hmmm so now on top of that.. we are going to have an increase in taxes as well.

IF ABOVE is still financially not sustainable, start reducing services to the level of other countries. Clearly some provide just AS GOOD of healthcare as USA does today.

Hmmm.. so you just stated that businesses and employees are going to pay the same they are today.. that general taxes might go up.. that the economy will have less jobs and wages in healthcare (the largest expanding employer right now).. and less jobs in insurance

And NOW.. we are going to reduce services to the level of other countries (for example being 10 in effective care rather than 3.. or be rated 10 in timeliness versus 5).

Well crap man.. you sold me.. so we are going to pay the same.. or get taxed more.. have less wages and jobs in the community.. and likely end up with less services than we have now.. so that we can worry about our "healthcare per dollar".. wow.. lets be more expensive or at least as expensive, hurt our economy, and in the end reduce services.

Well.. at the very last.. you are finally honest.

And sir.. you could not have made my point any better than by your own words.

 

[imagep]

Right now, Medicare has about 60 million recipients being supported by about 150 million workers. AND it's running out of money. Now change that so those workers are now paying for the healthcare of 330 million and do the math.

They already ARE paying for the healthcare of 330 million. Do you really think that only people on medicare are purchasing healthcare?

We pay either the government, the insurance company, or we pay direct to the provider. I could care less who I pay, I just want the best care for the lowest cost. I don't think I am currently getting that.

 

[imagep]

Yes. But now companies have no healthcare costs. They can pay more taxes in place of that

Or alternatively, individuals like myself who do not get free employer provided insurance would have less healthcare cost and no insurance cost. they could then afford to pay more in taxes.

 

[Slavister]

The purpose of "closing" statements was to STOP disassembling them line by line but to be final summaries. I guess you wanted to keep going. I guess I'll give you another reply, but I'd like to wind down...

those that we DO cover pay more and more for their healthcare

Factually wrong.. people for healthcare insurance.. not healthcare for the most part. Actual expenditure on healthcare has been relatively controlled versus the increase in demand.

https://wire.ama-assn.org/ama-news/growth-health-spending-slows-post-aca-era

Factually wrong. From the FED:

since 1948, the price of medical care has grown at an average annual rate of 5.3% while the entire basket, headline CPI, has grown at an average annual rate of 3.5%. In the past 20 years, in the regime of stable inflation, headline CPI has grown at an average annual rate of 2.2%, whereas the price level of medical care has grown at an average annual rate of 3.6%—about 70% faster

Note: This measures out-of-pocket expenses only, not what insurance pays! If you want to also look at what insurance pays... Continuing on from the same link...

For healthcare, however, there’s a great deal of other spending going on. And the inflation rate of that spending is something a policymaker might need to know. Luckily, the BEA puts together a more holistic price index for healthcare spending—the health expenditures price index—which we add in the graph below. Although the history of this series is shorter, this measure of healthcare prices is still rising considerably faster than headline CPI: In 2001-2013, this measure of healthcare inflation rose almost 4% per year, whereas headline CPI rose 2.3% in this period and the other healthcare CPI rose 3.9%.

Next, regarding bankruptcy, I will agree there is conflicting information and picture is murky on the numbers. There are certainly plenty of links supporting what I said (here is a new one I found today). And there are links like yours that paint a different picture. There is also a lot of back-and-forth between academics studying this. So, I won't argue this point further.

However, here is another statistic that still shows related part of this problem (from Commonwealth Fund):

More and more people spend higher percentage of their budgets on medical needs

Factually incorrect:
https://wire.ama-assn.org/ama-news/growth-health-spending-slows-post-aca-era

Out-of-pocket spending share has been on a steady decline for 50 years

I said people pay more. What you quoted is that they pay lesser PERCENTAGE of healthcare expenses. Guess what. When overall growth is high, even when share is less, people can still pay more. Hard concept, right? Either that, or you are intentionally misleading once again. Look again at quotes at the beginning of this post - they show increase in out-of-pocket expenses that is significantly outpacing general inflation.

 

[Slavister]

some of that means greater wait times.. some of that means less choice in providers.. some of that means that insurance is LESS coverage than what americans get now.

In some countries they do NO WORSE than how we do on all these metrics. Yet, ALL countries pay significantly LESS for their healthcare.

Another issue that I did not bring up, but might as well mention now is another HUGE HIDDEN COST that for American healthcare - TIME spent by patients dealing with insurances and complicated healthcare system. That TIME is not FREE, yet we spend A LOT more times on average vs rest of the world. I know this from personal experience and experience of others.

Every discussion to date has completely missed this major cost in our system IMO.

and 8% decline in healthcare.. which would get us to the level of GDP that other countries pay.. means a decline of TWICE what GDP declined in the Great Recession. But you want to gloss over that.

I already explained many times that propping up "fat" in healthcare industry for the sake of maintaining GDP is the same argument as making our laws more complex on purpose to increase lawyer and accountant employment, or making our Government more bloated just for the sake of useless (but paying) jobs, or making our healthcare EVEN MORE complex to again improve employment. Lots of industries went away or died in the past. A lot more will.

I simply don't buy that increasing inefficiencies (or not cutting them) leads to better economy. If we drop GDP by 8%, so be it. Perhaps there is a way to do this SLOWLY, to phase this in, or in some other way that distributes this effect over time. Or perhaps we don't even need to drop it by 8%. Either way, this circular reasoning that we need to OVERPAY for healthcare BECAUSE jobs are at stake is a non-starter IMO. We might also want to do this when economy is doing great and expanding - that will help too!

Skipping rest of your post as that's again rehashing of same old points.

 

[Slavister]

I see.. so in other words.. no savings at ALL!

Wrong. Savings will come from paying less for drugs, for when you actually get services, AND not paying those huge deductibles on HDHP.

there will be fewer providers

No, not fewer providers as I already discussed earlier. Fewer employees of insurance companies. Fewer employees for billing and administrative staff at providers. But NOT fewer providers.

Hmmm so now on top of that.. we are going to have an increase in taxes as well.

Hopefully NOT. ONLY IF needed.

And NOW.. we are going to reduce services to the level of other countries

Hopefully NOT. ONLY IF still needed.

 

[Boo Radley]

Sorry, no. You assume what your employer and you pay for group insurance will directly translate to the cost of single payer. Not even liberal think tanks say that.

Not about thinking. It's about how much you already pay and that you will likely pay no more. Again, I've presented factually what we already pay.

 

[Boo Radley]

Pick one and we will go from there.

The OP addreses number one and every single payer system pays less than we do. So number one has already been addressed.

The second one: Politics. If part of our predicament has been that we've collectively avoided hard decisions for decades, I don't see much hope that single-payer would solve it. There are many reasons we pay so much for health care: we employ 'too many' people in that industry (including blue and white collar jobs), we pay them wages that are 'too' high, we get 'too many' services and have 'too much' capacity, we use 'too many' medicines, and have access to new drugs and new technologies 'too quickly.' And so on. [Note that it's the promise these "problems" will be fixed that leads to the constant discussion of increasing wait times.]

If we've collectively decided that this isn't worth the cost and we're willing to give it up (and I don't believe that we have agreed this), then we're still going to face individual defections from those conclusions. Maybe we in the U.S. have too many hospitals, but your local Congressman and local politicians certainly aren't going to be in favor of your local hospital closing. The politics of hospital closures and layoffs will be even tougher than the politics of base closures, affecting every single Congressional district in the country. Putting tough decisions about cold, hard realities in the political sphere seems to me less likely to produce needed outcomes, not more.

Where we employ too many is in the administrative paper work side which has to address too many different means for payment, including nonpayment which often occurs in the emergency room. There's also a cost for having people unable to get adequate care, which spills over into the healthy population.

However the argument seems to be we can't get the will to do what is right, though I think he misses what is right. It hurts us not to have hospitals that everyone can get to. Real people suffer and wwe really don't want everyone living in big cities. Once we stop pretending this is the best we can do, we have the ability to not only do as well as other nations, but better.

Medicine is going to cost us. As Bill Clinton once said in another context, you're going to pay. The question is what do we get for the money? We can't likely pay more than we are paying while getting more care for more people. And the rich can always spend more if they want more.

 

[Bullseye]

Not about thinking. It's about how much you already pay and that you will likely pay no more. Again, I've presented factually what we already pay.

You keep chanting that mantra and yet several studies from all points in the spectrum say you're wrong. Right now I'm paying only for my own coverage, under single payer I'd still be paying that PLUS coverage for many others.

 

[jaeger19]

Factually wrong.

Nope factually correct. I gave the link that proves it. Growth in costs have been controlled in relation to DEMAND. sure.. when you look at the fed.. cost have gone up past inflation.. DUH/.. Why would you NOT expect that to happen when you have a tremendous increase in demand because of the aging of America.? This isn't due to "artificial bloating".. this is due to real world increases in demand. HUGE increases in demand with the aging of the single biggest generation. In fact.. what is artificial is that their has been artificial actions on the part of the government to purposely DECREASE reimbursement.. in the face of increasing demand. and that's been going on since the Balanced Budget Act in the late 1990's

However, here is another statistic that still shows related part of this problem

No its not the related problem..

But your graph is largely explained by 1. Not having everyone covered.. 2. American work situations.. like afraid to take off work to go to the doctor to be given a "point" even though by law they are allowed to go.

I said people pay more

Not really.. you said they payed a higher percentage of their budget on medical needs. In any case.. their percentage of out of pocket costs is dropping.

In some countries they do NO WORSE than how we do on all these metrics

yep. And some do worse.

Yet, ALL countries pay significantly LESS for their healthcare

Yep... and so?

I already explained many times that propping up "fat" in healthcare industry for the sake of maintaining GDP is the same argument as making our laws more complex on purpose to increase lawyer and accountant employment, or making our Government more bloated just for the sake of useless (but paying) jobs, or making our healthcare EVEN MORE complex to again improve employment

Yep.. you have made that argument and I have shown over and over again why that's a false argument. One.. we are not "propping up fat".. The rate of increase in healthcare has been because of DEMAND.. large increases in demand.. which you want to ignore. AND you ignore that the government has actually taken large steps to DECREASE reimbursement.. even though DEMAND has been increasing.

Your argument that there is fat.. is based on the premise.. "Well.. well.. we pay more than other countries"... that's where you claim there is fat. WELL.. we pay a lot of wages more than other countries. IF we followed your argument.. well then.. we should all go lower wages for everyone to say.. a dollar an hour.. because why are we "paying for that fat".. when countries like mexico and china pay less.

I simply don't buy that increasing inefficiencies (or not cutting them) leads to better economy

Yeah and again the lie. YOU cannot get your savings by "cutting inefficiencies".. heck even yourself have indicated that providers are going to either lose jobs or they are going to take pay decreases... that's not "inefficiencies".. and frankly.. you are in fantasy land if you think there is even say 4% of GDP in savings from "going from multiple insurances to one".. and you are wanting to decrease healthcare gdp by 8% to get to what other countries pay.

Stop lying.

 

[jaeger19]

Wrong. Savings will come from paying less for drugs, for when you actually get services, AND not paying those huge deductibles on HDHP.

.

You just stated that employers and employees would be paying the same.. that would mean .. well they would be paying the same.. in other words.. no savings.

No, not fewer providers as I already discussed earlier.

Fantasy.. if you think that cutting provider pay is not going to decrease supply of providers.

 

[jaeger19]

The OP addreses number one and every single payer system pays less than we do. So number one has already been addressed.
.

Sure.. hey.. if you want to reduce our GDP by 8% to get there.. awesome.. of course in the great recession.. GDP dropped by 4%.. and we would be doubling that.

Where we employ too many is in the administrative paper work side which has to address too many different means for payment, i

this is overblown.. the too many doesn;t come from "too many different means of payment".. it comes from the number of claims.. and outlier insurance that require more hoops.

There's also a cost for having people unable to get adequate care, which spills over into the healthy population.

There is some truth.. getting everyone covered would go a long way to solving that.

However the argument seems to be we can't get the will to do what is right, though I think he misses what is right. It hurts us not to have hospitals that everyone can get to. Real people suffer and wwe really don't want everyone living in big cities. Once we stop pretending this is the best we can do, we have the ability to not only do as well as other nations, but better.

The issue here is how. Because we also are pretending that single payer is going to be this simple fix.. and as Greenbeard and I..and even you allude to.. its not.. In fact.. there is a good bet that it will make things worse for the 85% of americans that have health insurance.

Actually we could make things a lot better.. and it would be easier and in a lot smaller steps (easier to take politically).. but that can't get done in an environment in which either side.. (and its mostly liberal lying I will say. sorry but the idea that we can pay what other countries pay.. without a huge hit to our economy is simply a whopper. ).. are willing to not deal with reality.

 

[jaeger19]

You keep chanting that mantra and yet several studies from all points in the spectrum say you're wrong. Right now I'm paying only for my own coverage, under single payer I'd still be paying that PLUS coverage for many others.

No offense but you are not paying for your own coverage.,.. you are paying for everyone else as well.. that's how insurance works.

Wait.. unless everyone else is paying for you.. because you are using your insurance more than you paid in.

 

[Bullseye]

No offense but you are not paying for your own coverage.,.. you are paying for everyone else as well.. that's how insurance works.

Wait.. unless everyone else is paying for you.. because you are using your insurance more than you paid in.

Well, no, not exactly. Everyone WHO PAYS is sharing the cost of care for those people. KEY words "WHO PAYS". With single payer there would be a large crowd of those NOT PAYING but still eligible for full coverage. The only way to make that work is to make those WHO PAY, pay more. Current Medicare, for example relies on around 150 million workers to finance the benefits for about 60 million recipients. Even at that approximately 2 1/2 to 1 ratio Medicare is running out of cash. Now consider how 150 million workers would pay for 325 million Americans.