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You are not buying Health Care. You are buying insurance that costs an arm and a leg. And when you need it you have a monster co-pay. And if you have any major problems in the end you will go bankrupt just like before. Benefits the insurance companies. Another program where Obama did not bother to do his homework.
And thinking through what 2sleepy suggested, it might not be as hard to get there as many would have you believe. Drop Medicare age to 60 and add all the family benefits (be able to cover dependents up to age 26). Then in a couple of years drop the age to 55. Couple of more, drop it to 50. Couple of more - everyone. Don't invent a new system; work with the one we have and expand it to all.
It would not be as easy as you think. It would still have to be tweaked. Medicare pays some doctors well, while others barely break even. They do this based on competition. Some specialties are basically forced to take medicare patients by the nature of the specialty. Especially the hospital-based specialties. Other specialties can choose not to take medicare patients, and those are the specialties that medicare pays well, in order to attract them. With "medicare for all", as it is now, you would see certain specialties disappear overnight. Some specialties count on private insurance to pay them well so that they can afford to treat the medicare (and medicaid) patients. For example, if I got rid of all of my medicare and medicaid patients, I would work 40% less while taking no hit in salary at all. I might even make more because medicaid doesn't even pay enough to cover the expenses involved in treating their patients. Conversely, if everyone is medicare, I literally can't make enough to pay my malpractice insurance and feed my family. I will be forced to go back and do another residency in a different specialty, or leave medicine altogether.
It would not be as easy as you think. It would still have to be tweaked. Medicare pays some doctors well, while others barely break even. They do this based on competition. Some specialties are basically forced to take medicare patients by the nature of the specialty. Especially the hospital-based specialties. Other specialties can choose not to take medicare patients, and those are the specialties that medicare pays well, in order to attract them. With "medicare for all", as it is now, you would see certain specialties disappear overnight. Some specialties count on private insurance to pay them well so that they can afford to treat the medicare (and medicaid) patients. For example, if I got rid of all of my medicare and medicaid patients, I would work 40% less while taking no hit in salary at all. I might even make more because medicaid doesn't even pay enough to cover the expenses involved in treating their patients. Conversely, if everyone is medicare, I literally can't make enough to pay my malpractice insurance and feed my family. I will be forced to go back and do another residency in a different specialty, or leave medicine altogether.
I don't think it will be easy. I just see that as the simplest path to take to get to single payer. Yes, it would have to be adjusted so docs still make money. It really seems like a bad result should be part of your medical insurance and not something you sue the doctor for when there is no gross negligence. A doc that is getting bad results too often needs to be fired. Way too simple, I know...
It's not just the insurance system that is broken, it is the entire provider system. Do you know what a replacement hip for my dog cost me? $600. Do you know what the same technology, just as easy to make, costs for people? $40,000. Same materials, same technology, different profit structure. Have you tried to get a doctor's appointment lately? They are booking 3 months out. We need a couple dozen new medical schools to keep up with demand, but we don't have them. I see doctors who graduated from medical school in other countries, because we can't supply enough of our own. Of course the docs can charge whatever the traffic will bear, because they have no competition.
If you think health insurance is expensive now, just wait a few years. Health care costs are going up a lot faster than home prices, and they never drop.
I'm sorry, but I absolutely do not believe this. The procedure alone would have run thousands of dollars in my local area. Here is a more reasonable estimate, between $4,400 and $4,700.
It would not be as easy as you think. It would still have to be tweaked. Medicare pays some doctors well, while others barely break even. They do this based on competition. Some specialties are basically forced to take medicare patients by the nature of the specialty. Especially the hospital-based specialties. Other specialties can choose not to take medicare patients, and those are the specialties that medicare pays well, in order to attract them. With "medicare for all", as it is now, you would see certain specialties disappear overnight. Some specialties count on private insurance to pay them well so that they can afford to treat the medicare (and medicaid) patients. For example, if I got rid of all of my medicare and medicaid patients, I would work 40% less while taking no hit in salary at all. I might even make more because medicaid doesn't even pay enough to cover the expenses involved in treating their patients. Conversely, if everyone is medicare, I literally can't make enough to pay my malpractice insurance and feed my family. I will be forced to go back and do another residency in a different specialty, or leave medicine altogether.
But, why not medicare for all with the ability for the consumer to purchase supplement plans from insurance companies? I am on medicare but I have a very robust supplement paid for by my ex-employer. I can see any specialist in the BCBS regular network. Medicare pays whatever their allowance is first, then BCBS pays the rest up to their limit which appears to be close to the billed amount. The poor would be slightly better off because medicaid is stingier in what they pay providers than medicaid, and people who can afford it could purchase any kind of supplement that they can afford. The other possible outcome would be that more patients might be able to see high priced specialists so their revenue might be more dependent upon volume than what an individual patient pays.
Or how about rewarding physicians for treating medicare/medicaid patients? drop 10% of the student loan debt of a physician for each year in which they accept those patients.
I'm sorry, but I absolutely do not believe this. The procedure alone would have run thousands of dollars in my local area. Here is a more reasonable estimate, between $4,400 and $4,700.
Still a far cry from $40,000, but if the dog dies under anesthesia the vet doesn't get sued for millions of dollars.
It costs $300 to get dogs teeth cleaned because they won't do it without anesthetizing the dog. I hate to even consider what a hip replacement for one of them would cost
People concentrate on doctor's salaries too much. Physician reimbursements make up only 20% of health care spending, and half of that goes to malpractice insurance, practice expenses, and student loan payments. So it is really more like 10%. If you cut doctor's salaries 20% you might see a 2% reduction in health care costs. You would barely even notice it in your health insurance premiums. The "business" of medicine accounts for 30% of health care spending. If you want to save money, streamline the process. I have so much red tape mandated by the government and insurance companies that my group needs an entire office staff just to deal with the insurance companies. Then the insurance companies need to pay many people on their end to deal with my bills. It should be an easy process. Then there is the pharmaceutical industry and medical device industry. Many people in those fields make a lot more money than doctors do. We don't mind paying a lot for that, because those are "businesses". They are "supposed to make a lot of money". I don't necessarily begrudge them making a good salary either, but in the context of health care spending, it seems like most people concentrate on the doctors 20%, and rarely on the other 80%.
Baloney.
1. If there wasn't so much malpractice, malpractice insurance wouldn't be so high.
2. Practice expenses. Okay. But does a doctor really need to charge $1 per page of general advice that the patient can find right on the internet (literally the same document)?
3. Gee, when I was educating your kids, I didn't expect you to reimburse my college loans.
4. 2%? I'll take it. Let's see, for my $35,000 surgery, that would have been $700. I notice $700. And so does my insurance company.
5. Do you know why there's so much red tape? Doctors who cheat. Practices that let out confidential information. Doctors who do unnecessary procedures. Etc. Once those types of abuses begin to happen, people want accountability. It's present in all professions.
I like my doctor very much. I live in a $225,000 townhouse. Very comfortable. No complaints. My doctor lives in a 2.5 million dollar house. Yeah, I feel real sorry for doctors.
Every drug is known to do harm. If we didn't ever give drugs that did harm, we would never give any drugs at all. Aspirin is a wonderful drug on many levels, but in a small percentage of the population it will, and does, cause bleeding in the intestinal tract or even in the brain. It doesn't mean that nobody should take aspirin. It is literally a life saver for many people. It's all about risks verses benefits.
Yes, that is true. I am trying to balance my need right now for omeprazole and the recent study that showed that omeprazole patients have a higher incidence of heart attack. It may not be causal, but it is a concern. So far I am managing to cut back substantially.
You are not buying Health Care. You are buying insurance that costs an arm and a leg. And when you need it you have a monster co-pay. And if you have any major problems in the end you will go bankrupt just like before. Benefits the insurance companies. Another program where Obama did not bother to do his homework.
I'm not experiencing any of that. I don't have monster copays, even with 3 surgeries in 3 years. For a $35,000 kidney surgery I paid less than $300. For a $25,000 thyroid surgery I paid less than $250. For a double eye surgery costing about $10,000 I paid less than $200.
I think maybe you're the one not doing your homework.
It would not be as easy as you think. It would still have to be tweaked. Medicare pays some doctors well, while others barely break even. They do this based on competition. Some specialties are basically forced to take medicare patients by the nature of the specialty. Especially the hospital-based specialties. Other specialties can choose not to take medicare patients, and those are the specialties that medicare pays well, in order to attract them. With "medicare for all", as it is now, you would see certain specialties disappear overnight. Some specialties count on private insurance to pay them well so that they can afford to treat the medicare (and medicaid) patients. For example, if I got rid of all of my medicare and medicaid patients, I would work 40% less while taking no hit in salary at all. I might even make more because medicaid doesn't even pay enough to cover the expenses involved in treating their patients. Conversely, if everyone is medicare, I literally can't make enough to pay my malpractice insurance and feed my family. I will be forced to go back and do another residency in a different specialty, or leave medicine altogether.
I doubt anyone here will believe that bolded part at all. After all, some types of practices are for mostly people who are in the Medicare age bracket, and they seem to be doing extremely well.
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