beachbumbabs
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beachbumbabs
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Rigondeaux
March 9th, 2017 at 1:28:02 PM permalink
Quote: Paradigm

Well the recent election, as opposed to a "poll" says it isn't quite that big a discrepancy in favor of universal/Obamacare...you can jump up and down about how bad Trump is for this and that, but he got a lot of votes based on "Repeal & Replace"...I am choosing to look as the 49/51% popular vote for the two Presidential Candidates as a closer approximation of the country's views on healthcare than the sample poll you cited. Polls haven't worked out very well in predicting the real outcome of things recently.



At the risk of further derailment of this thread (though the conversation is central to the OP's argument), I think the question has been hopelessly obscured by decades of anti-public option advertising by private insurers, and partisan politics.

The fact is that Medicare controls costs best, and returns best value both in extremely low administrative costs (including no shareholders, which I think is sometimes not included in private care admin costs; not sure) and in having huge blocks of patients for which to negotiate low rates (very like Walmart). It's just a fact that stands alone, with many years of records to prove it.

The proposals which push marketplace expansion across state lines are lobby - driven by companies wanting access to a larger client base. It's possible that would lead to somewhat lower premiums through competition, but ultimately the user is paying shareholders and billionaire CEO's a hefty premium.

They can't match the value Medicare provides just because of these additional burdens on the annual budget. But they can lobby and bribe Congress (another budget inflator) and advertise using scare tactics and slanted persuasion (another budget inflator) in order to protect their profit margin. I don't believe it's in the public's best interests to continue to sustain this model.

I do think there's a place for a layered plan over Medicare. Insure everyone, not just the over-65's, at that base level. Make it mandatory, and remove the cap on fica payments. Include fica payments in public assistance calculations as well as paycheck deductions.

Allow supplemental insurers to sell gap insurance, long-term care, pharmacy and medical device coverage, whatever perks they can develop. But the days of big private insurers screwing people on base coverage need to be over.
"If the house lost every hand, they wouldn't deal the game."
Paradigm
Paradigm
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March 9th, 2017 at 4:54:55 PM permalink
I know, propaganda, lies and all that stuff...Medicare wins! It's the best, most efficient system out there...I'll stipulate to that and offer no counter argument or facts to that statement. That being said,, I would like to participate in a system other than Medicare/Single Payer Plan for my own "insane" reasons. So you do you and let me do me...how about that? I don't want to be in your pool of insureds, I want to be in a different pool...but still covered against shoving my health care costs on the local ER.

Quote: beachbumbabs

I do think there's a place for a layered plan over Medicare. Insure everyone, not just the over-65's, at that base level. Make it mandatory, and remove the cap on fica payments. Include fica payments in public assistance calculations as well as paycheck deductions.


So make everyone earning more than $118.5K per year (of earned income) foot the increased bill for a single payer plan that 49% of voters in November didn't want...seriously Babs, do ya see how flawed that comment is and why it will never come to pass. Why didn't you say increase everyone's Medicare Tax, even the poor, that opts into the "Medicare at Any Age" coverage by 3%? You can't pass off the "super efficient/no waste" costs of increasing Medicare to those that opt in on to others that don't want it and opt for a private insurance plan. This single payer plan isn't free for those that opt for it...what's next, free college education for all ("wait, I heard about that recently as well").

Plus if the service levels and costs of the super efficient high quality Medicare plan are so great, it will push private insurance out of business through competitive forces...why don't I believe that will happen?

Quote: beachbumbabs

Allow supplemental insurers to sell gap insurance, long-term care, pharmacy and medical device coverage, whatever perks they can develop. But the days of big private insurers screwing people on base coverage need to be over.


You can't have your cake and eat it too...either put the government in charge of your plan (and not my plan) and run with it. Don't think the government also gets to tell private insurance companies what they can and can't sell as health insurance to everyone else. If I am getting screwed by my private insurance plan, I'll take care of it...I don't need a Nanny Country to handle that for me...heck, if they screw me bad enough, I'll opt into the Medicare for All program. See how this is going to work?
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Rigondeaux
Rigondeaux
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March 9th, 2017 at 9:37:51 PM permalink
I guess you could look at any other service. Everyone pays for basic police protection (and harassment). If you want additional security, fine. Pay for it.

But, you can't have the wealthier half the population opt out because "nanny state." It would be an unmitigated disaster (see Robocop), just like our healthcare system is.

Meanwhile, every country that treats healthcare the way we treat police, fire, military, roads, etc. has a vastly superior system and like 91% of the population would never dream of switching with us.

It's a mute point because the people in a position to fix it are all bought off.
Paradigm
Paradigm
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March 9th, 2017 at 11:12:36 PM permalink
Quote: Rigondeaux

I guess you could look at any other service.


This is the fundamental difference between each side...half of the population looks at health services like "any other service" the government should provide, the other half doesn't think healthcare is a service the government should provide. I am not saying right or wrong, but this is where the divide exists and anyone making progress in this area needs to find common ground between these two philosophies.

The argument that all these other countries "are doing single payer/national health care and their citizens love it...so why wouldn't we love it too" simply doesn't hold water. The majority of Americans believe their country has a superior economic system to any other in the world...evidently a lot of the world feels that way as well. Why the heck else do so many folks want to immigrate here. When this country starts having net exodus of the population to the rest of the world, you can talk about how other countries in the world have a better system.
Quote: Rigondeaux

But, you can't have the wealthier half the population opt out because "nanny state." It would be an unmitigated disaster (see Robocop), just like our healthcare system is.


I didn't say the wealthier population opts out...I said you can't ask the wealthy to pay the entire cost for the single payer system via Babs suggestion of "uncapping FICA tax" to pay for it. Besides, why would wealthy people be more prone to opt out of the single payer system. The proponents jump up and down and say how great the service with be with so little of the funds going to administration. Sounds like if this were true, wealthy people would be smart to opt in, why in the world would anyone opt out if the premise were true? By the way, I would like to opt out.

Quote: Rigondeaux

It's a mute point because the people in a position to fix it are all bought off


Some folks, a lot actually, that use the current private insurance system don't want it changed. They aren't bought off, they just don't see anything that needs fixing. You can say they are wrong, fine...but they all get a vote on what gets changed in the system, just like you. And we lived under 3+ years of Obamacare and 49% just voted against it. No "Bernie would have won" tangents to deflect the Election Results...Trump still got 49% of popular vote and a vote for Trump was a vote against Obamacare...that was a pretty clear message.

I'll have to leave it there...both sides need to recognize the validity of the other sides angst and find a solution that serves both. The progressives want a new single payer system, give it to them and those that opt in to that system bear the costs. Those that want to maintain their private health insurance/healthcare, give it to them and let them fight it out in the marketplace with who to buy insurance from across state lines. Why does this need to be a binary decision? Everyone has an option to get coverage and that is the dream, right...more people with health insurance coverage. Why are some so bent on making the decision regarding the type of coverage?
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Rigondeaux
Rigondeaux
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March 10th, 2017 at 2:11:54 AM permalink
If it were possible to have a viable system that people could opt into and out of, that would be great. But I don't see how that would work.

Quote: Paradigm

This is the fundamental difference between each side...half of the population looks at health services like "any other service" the government should provide, the other half doesn't think healthcare is a service the government should provide. I am not saying right or wrong, but this is where the divide exists and anyone making progress in this area needs to find common ground between these two philosophies.



I think this is true of gun control, and some other issues. But not this one.

Firstly, this Trump thing is wrong. He won because he ran against a hated, repugnant, openly corrupt piece of trash, who ran an almost impossibly incompetent campaign. It doesn't prove much about any particular policy. Nor would Bernie's victory, (or the victory of any competent, non-hated Dem), in itself, have proven much.

Secondly, rejection of obamacare ain't rejection of anything but obamacare. Everyone agrees that it sucks. Trump even suggested at times that he would go for something more like universal care.

This is a naked power struggle. I post some variation of this every time. Do an image search for "heath care cost per capita" and you will find dozens of charts like this.


I acknowledge that there are some ideological extremists who oppose most any government program no matter what. But they are as crazy as commies and represent a small number of people.

We have a horrible, inefficient, life shattering health care system and it is designed to be that way by people who take bribes.

Quote:

The argument that all these other countries "are doing single payer/national health care and their citizens love it...so why wouldn't we love it too" simply doesn't hold water. The majority of Americans believe their country has a superior economic system to any other in the world...evidently a lot of the world feels that way as well. Why the heck else do so many folks want to immigrate here. When this country starts having net exodus of the population to the rest of the world, you can talk about how other countries in the world have a better system.



You certainly know this is a poor point.

First off, it's not like only the French have and like universal healthcare. Every wealthy country, and some poorer ones do. Asians, latins, and all the whites. And they all strongly prefer it. In other words, everybody who actually has experienced it, likes it, no matter their cultural background.

And 58% to 39% want it here, in spite of massive misinformation campaigns. How many of that 39% do you think know that Brits spend way less on healthcare than we do?

Second, like all of those countries, we have a mixed economy. It's not our economic system that is at issue. Australia is hardly a Stalinist state.

Third, most people like and stay in all those other countries too. And immigrate to them. It really proves nothing about health care, or gun laws, TV programming, popular shoe styles, or speed limits.

Quote:

I didn't say the wealthier population opts out...I said you can't ask the wealthy to pay the entire cost for the single payer system via Babs suggestion of "uncapping FICA tax" to pay for it. Besides, why would wealthy people be more prone to opt out of the single payer system. The proponents jump up and down and say how great the service with be with so little of the funds going to administration. Sounds like if this were true, wealthy people would be smart to opt in, why in the world would anyone opt out if the premise were true? By the way, I would like to opt out.



Well, I think you overestimate human nature. The sort of person who winds up rich, and certainly in DC, often just doesn't want a steak. The want to eat a steak while someone else eats from the garbage. It's not just about material gain, it's about having as wide a disparity in wealth and power as possible.

obviously, the wealthy would have to pay a big share of the costs, just like with the military or fire department. The money has to come from somewhere, and they have it all now.

The fact that universal care is more efficient overall, a matter of fact, doesn't mean the wealthy should want it. They prefer an inefficient system, where they get the best of everything, profit of others' misery, and don't have to pay for the care of others.

Whether they get that system, or we get one that benefits everybody is just a matter of slugging it out. And they pretty much already won.

Quote:

Some folks, a lot actually, that use the current private insurance system don't want it changed. They aren't bought off, they just don't see anything that needs fixing.



Really? I've just about never meet someone who likes our system. I was talking to a nurse the other day who told me her hospital charges $750 for an IV that costs the hospital $2. Why would anyone like that?

Hundreds of thousands are bankrupted by medical bills every year. And those costs, the courts, the divorces, the general misery are not factored into the costs in the chart above. And this could happen to almost any of us at any time. Why would anybody like that?

http://www.snopes.com/643000-bankruptcies-in-the-u-s-every-year-due-to-medical-bills/

Apart from wealthy people and CEos.

I do know people who oppose normal healthcare systems because they, for example, believe them to be much more expensive. Which is objectively false.
beachbumbabs
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beachbumbabs
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March 10th, 2017 at 3:07:39 AM permalink
Quote: Paradigm

I know, propaganda, lies and all that stuff...Medicare wins! It's the best, most efficient system out there...I'll stipulate to that and offer no counter argument or facts to that statement. That being said,, I would like to participate in a system other than Medicare/Single Payer Plan for my own "insane" reasons. So you do you and let me do me...how about that? I don't want to be in your pool of insureds, I want to be in a different pool...but still covered against shoving my health care costs on the local ER.


So make everyone earning more than $118.5K per year (of earned income) foot the increased bill for a single payer plan that 49% of voters in November didn't want...seriously Babs, do ya see how flawed that comment is and why it will never come to pass. Why didn't you say increase everyone's Medicare Tax, even the poor, that opts into the "Medicare at Any Age" coverage by 3%? You can't pass off the "super efficient/no waste" costs of increasing Medicare to those that opt in on to others that don't want it and opt for a private insurance plan. This single payer plan isn't free for those that opt for it...what's next, free college education for all ("wait, I heard about that recently as well").

Plus if the service levels and costs of the super efficient high quality Medicare plan are so great, it will push private insurance out of business through competitive forces...why don't I believe that will happen?


You can't have your cake and eat it too...either put the government in charge of your plan (and not my plan) and run with it. Don't think the government also gets to tell private insurance companies what they can and can't sell as health insurance to everyone else. If I am getting screwed by my private insurance plan, I'll take care of it...I don't need a Nanny Country to handle that for me...heck, if they screw me bad enough, I'll opt into the Medicare for All program. See how this is going to work?



Your number is incorrect : 49% of the country did not vote for Trump. 46.1% of those who voted did. Further, only 59.7 % of those eligible to vote did so, which means only 27.5% of the country voted for Trump. If you're going to use numbers to bludgeon me with your argument, they should be accurate.

I highly doubt that you can say with any accuracy that a vote for Trump was automatically a vote for private health care, either; they are not synonymous. There is at least some crossover among all 2016 candidates on either side of this debate. There are many single-issue voters whose issue was not healthcare, and higher priority issues for many others.



Healthcare barely made the top 5.

Your way has been tried. It doesn't work. We're in this mess because of privatized for - profit healthcare that has been unaffordable for many years. Basic healthcare should be like police and fire protection; spend more, get more if you like, but there has to be a base level that everyone supports. It has to be paid for.

You have a better idea on financing it, I'd love to hear it, but since you don't acknowledge the need for universal coverage, I doubt you've wasted a moment's thought on how we could pay for it.
"If the house lost every hand, they wouldn't deal the game."
odiousgambit
odiousgambit
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March 10th, 2017 at 3:21:14 AM permalink
Snopes is an internet site that debunks. The article is almost unreadable but isn't buying 643,000 a year.

I think one thing you can count on for sure is everybody in every country finds something they don't like about their health care system. I for one am very suspicious about claims that we should be 'more like Europe' no matter if it's about healthcare or if about something else. Europe is turning into a basket case.

Not to say I want to defend our system much. Mainly it's just that it is preposterously expensive; the care generally is very good. Half-ass attempts to get things under control lead to incidents of unconscionable billing - million dollar stays in the hospital and all that. I don't know that much about it, but my little exposures make me think that if you have something that for some reason isn't covered by insurance - you don't have insurance, or they don't take your insurance - then look out brother, how high is the moon?

Example: Previously I would pay thousands of dollars for a colonoscopy, and maybe it would have been newsworthy how much I was going to pay then, except my insurance at that time stepped in and said, in so many words, "no, although we aren't paying for this either due to deductible, you can't charge that much." It was still thousands. But how messed up is that kind of system to begin with?

My latest colonoscopy was supposed to be covered completely by my insurance, no cost to me - preventative medicine under ACA. It turned out the anesthesiologist didn't take my insurance, although nobody said a thing to me at the time. I got billed $1200; my insurance paid $400* and the rest I was to pay. Maybe because I paid so much before, and that it took 3 months for them to ask for the difference, I went ahead and paid. Later, talking to someone better informed, I find out I should have negotiated with them! He says you use the fact you are willing to pay immediately, point out that they agreed to pay less no doubt with insurance they do take, and make an offer!

Now, I'll be damned if I think this is a good system. I think I got surprise-billed for the 'how high is the moon' initial negotiating stance that they take with the insurance company! And I am just supposed to know I don't have to pay that? What? Who can defend this kind of stuff? And believe me, not everyone is well suited to be a negotiator. It's just all wrong.

*Not a contradiction to 'didn't take my insurance'. Confusing enough for you? The $400 is what they would pay if they took my insurance. Since the anesthesiologist didn't take my insurance, my insurance company actually sent me a check for this $400! Can you believe it? I think this is why it took them 3 months to bill me.
"Baccarat is a game whereby the croupier gathers in money with a flexible sculling oar, then rakes it home. If I could have borrowed his oar I would have stayed." .......... Mark Twain
Nathan
Nathan
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March 10th, 2017 at 4:20:46 AM permalink
Quote: odiousgambit

I didn't know this. One of the reasons my g.d. health insurance payment is so high is it covers gambling disorder treatments. WTF?

http://www.sltrib.com/home/5028000-155/casino-industry-dont-dump-gambling-disorders



That is kind of messed up that you have to pay for gambling addiction treatments.
Guy "won" less than his bet and the slot machine had the audacity to tell him he got a big win! SMH! Also, the Nintendo cartridge is so much more important than the Nintendo console. Without the cartridge, the Nintendo console is just a useless box.
Paradigm
Paradigm
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March 10th, 2017 at 9:49:14 AM permalink
Quote: beachbumbabs

Your number is incorrect : 49% of the country did not vote for Trump. 46.1% of those who voted did. Further, only 59.7 % of those eligible to vote did so, which means only 27.5% of the country voted for Trump. If you're going to use numbers to bludgeon me with your argument, they should be accurate.


OK 46.1% of votes were for Trump and 48.2% of votes were for Hillary...so, 46.1%/(46.1+48.2) = 48.9% of those that voted for Trump or Hillary, voted for Trump...I rounded to 49%, split hairs if you want.

Not sure why your "59.7% of eligible voters" is relevant...OK so 28.8% of the country voted for Hillary and 27.5% voted for Trump...who cares about diluting the numbers by the percent of eligible voters that actually voted. Are you really asserting that the 59.7% of the country that voted doesn't pretty accurately represent the current state of thinking by 100% of the public? That's conclusion is inaccurate.
Quote: beachbumbabs

I highly doubt that you can say with any accuracy that a vote for Trump was automatically a vote for private health care


I think I can..."Repeal and Replace" was a pretty big part of the Republican platform in both Presidential and Congressional races...seems like the Republicans didn't pretty well across the board in November if memory serves me correctly.
Quote: beachbumbabs

You have a better idea on financing it, I'd love to hear it, but since you don't acknowledge the need for universal coverage, I doubt you've wasted a moment's thought on how we could pay for it.


I guess my suggestion of some type of "Medicare at Any Age" that you could opt into vs. private insurance is not an "acknowledgement" of a need for some universal basic healthcare coverage, OK, but I think it counts as acknowledgement.

How to pay for it...I think those that opt into Universal Care should pay for it. Everyone benefits from Police and Fire Protection and so it is paid for with everyone's taxes. Not everyone wants to use/benefit from a Universal Health Care/Single Payer health care system, so everyone shouldn't pay for it.

Besides as all the proponents have pointed out, the single payer system is going to be "so efficient" remember. Surely a re-direction of the current private insurance payments (or some other payment that the Opt Ins can afford) being made by those that opt into the new plan should more than pay for it, right?
Quote: beachbumbabs

If you're going to use numbers to bludgeon me with your argument


OK, I am done here...not interested in "bludgeoning". Your plan won't happen today because a lot of America doesn't want it...you can argue that fact with "polls", etc. I'll just stick to actual votes of 57%+ of eligible voters...those "polls" have been pretty bad in predicting actual outcomes recently.

Or you can argue about how it would be so efficient...the majority of America doesn't believe you.

Or you can argue about how the current system is a disaster, but it has worked just fine for me and I have paid for 100% of my own insurance costs and medical expenses for the last 22 years and a portion of my employees insurance for the last 20 years. It works fine for many others as well despite the claims to the contrary...why do you think Obamacare is hated by so many? And the votes say it is so stop disputing that.

The only hiccup coming with the implementation of Obamacare, which until this year, prohibited me from reimbursing any portion of my employees personal health insurance policy premium costs. Wait, I thought Obamacare only impacted Employers with 50 or more employees...I have one full time employee...broken government plan promises but I am sure the new and improved "Universal Plan" will be different. Can you tell me again how I opt out?
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Paradigm
Paradigm
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March 10th, 2017 at 9:59:45 AM permalink
Quote: Rigondeaux

Really? I've just about never meet someone who likes our system. I was talking to a nurse the other day who told me her hospital charges $750 for an IV that costs the hospital $2. Why would anyone like that?

Hundreds of thousands are bankrupted by medical bills every year. And those costs, the courts, the divorces, the general misery are not factored into the costs in the chart above. And this could happen to almost any of us at any time. Why would anybody like that?


I like my private medical insurance that I pay for 100% and based on its coverage have zero chance of going bankrupt due to medical costs. You do you and I'll do me...how about that?

You know the hospital doesn't get paid $750 for that IV...that crappy, disastrous private insurance company empire tells them to take $15 in payment for it or they won't be part of their network and the hospital says "OK". I am good paying $15 for an IV that costs $2 when it comes with a trained nurse administering its implementation.
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