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A group of us were having a discussion regarding National Healthcare. Many thought that if there was National Healthcare in the United States that would mean the end of private care doctors. This is clearly wrong. In many countries with National Healthcare private doctors still exist. If you don't want to use the National Healthcare system then you can just go to a private doctor and pay for their services, otherwise you could just go to a clinic and see a doctor.
At a minimum, everyone would have healthcare, they wouldn't have any premiums to pay, no co-pays, no prescription drug costs, no deductibles, etc. They would have to pay a bit more in taxes to pay for it, but it would be far less than the premiums, deductibles, co-pays, etc. The money currently used on paying for insurance would be used to purchase other items (education, houses, cars, clothing, etc.) that would stimulate the economy and provide jobs.
Every other western nation has national healthcare (Canada, Sweden, Japan, Denmark, Norway, Europe, Britain, Taiwan, to name a few) except us. Why shouldn't we? Aren't we smart enough to implement something that other nations have? Aren't we worthy enough to get it?
IMO the resistance to this will come from the unions and workers who get top quality health insurance at little cost. They won't want to pay the extra money in taxes to get par for the course insurance. I also don't believe our version of national health care will be without deductibles or co payments. I envision more like Medicare 80/20 split with private insurance still being involved if single payer is implemented.
Vermont has looked into universal health and decided against it as the taxes would be prohibitive (I have read about an increase of up to 18% of income just to cover this.) This is from a relatively wealthy, low population state. We have seen how expensive Obamacare policies are to the unsubsidized. just imagine how expensive the premiums will be if we extrapolate this out to the entire population of the US. Then you need to tax everyone to pay for this. Not sure you will get the political support needed as I am not sure the tax will be significantly less than the costs for insurance coverage are now. I am still waiting for my $2500 in savings Obama promised me under Obamacare, lol.
I don't believe Sanders' claim about a 2% payroll tax increase in people and 6% in business being enough to cover the costs associated with the program. Forbes claims it will increase Federal spending by 55%. Even Paul Krugman, a left sided economist isn't for it. He thinks the "haves" will fight to much to not have it succeed that he feels tweeking Obamacare is the better answer. We have already see the "haves" get the Cadillac tax plan delayed. Do you think they will suddenly decide to pay more in taxes than they pay for insurance coverage now? These are usually the left leaning union people, until it affects their wallet.
Last edited by NSHL10; 01-22-2016 at 11:08 AM..
Reason: sp
Every other western nation has national healthcare (Canada, Sweden, Japan, Denmark, Norway, Europe, Britain, Taiwan, to name a few) except us. Why shouldn't we?
Check the news. Many of those national healthcare systems are a mess:
Shortage of health care professionals is a common issue - in the US, as well. Medical residency spots are limited and have been for years. It has long been predicted with the advent of the ACA that more people would be seeking health care - and medical provider shortages would become more pronounced.
Clearly, there aren't enough resources in the world to provide adequate health care for all. In other words, the world is overpopulated - so those who are poor or without access - for whatever reason - will die. Some things will never change - no matter where one lives - or under which system.
Be that as it may, all the hoo ha about problems in other systems - US is still down the list on measurable outcomes - especially considering the cost - which, in the US, is outrageous. $15,000/yr++ for family health coverage; $6K-$12k deductibles??? - unless one is fortunate enough to be covered by a generous employer plan - or POOR enough to get their medical care (with quality as a variable) for almost no cost.
Last edited by Ariadne22; 01-22-2016 at 05:16 PM..
A group of us were having a discussion regarding National Healthcare. Many thought that if there was National Healthcare in the United States that would mean the end of private care doctors. This is clearly wrong. In many countries with National Healthcare private doctors still exist. If you don't want to use the National Healthcare system then you can just go to a private doctor and pay for their services, otherwise you could just go to a clinic and see a doctor.
At a minimum, everyone would have healthcare, they wouldn't have any premiums to pay, no co-pays, no prescription drug costs, no deductibles, etc. They would have to pay a bit more in taxes to pay for it, but it would be far less than the premiums, deductibles, co-pays, etc. The money currently used on paying for insurance would be used to purchase other items (education, houses, cars, clothing, etc.) that would stimulate the economy and provide jobs.
Every other western nation has national healthcare (Canada, Sweden, Japan, Denmark, Norway, Europe, Britain, Taiwan, to name a few) except us. Why shouldn't we? Aren't we smart enough to implement something that other nations have? Aren't we worthy enough to get it?
OK, I'll wait for the incoming on this one!!!
BBM~~ from your quote..while a lot of what you said is fairly correct..BUT in such systems, as in Canada..ALL physicians are Private practice ( including mine)..What you suggest is a 3nd tier system....which does exist..but only those who are NOT part of the Universal/Province by province..ala..Out of country types..who have NO standing within the Universal system..so have to pay upfront..(get receipt so can bill Insurance once back home)
In Canada..Most Physicians ( if not all) are part of the system..from walkin-clinics thru to Family Practice onto Experts..referred to by attending FPractice physician/W.I.Clinic MD/ ER physicians ..which is ALL covered ....
Those who have HC Cards..just register..and voila..physician..no matter who you see or where you are..present that card..and they enter bill to system by code in order to get paid within 30 days.....
If out of Province but still in Canada..Provinces have reciprocal recognitions..thus it's seamless...present Ontario HC card to Alberta physician/Hospital/Clinic..and to my knowledge they present that bill to Ontario system..No muss no fuss...
The above could work in USA..IF only ALL States would agree to get on board..instead of declining coverages..all due to Politics..NOTHING TO DO WITH caring for patients..IN fact by denying it..refuses patient care unless they have deep pockets..or if destitute..then ER$$$ more costly !! ...Taxpayer gets on the hook...
My view is that American's HC system is so multi-tiered..that due to political quagmire..many find it difficult to even know what coverage they have within their own state..let alone what's covered OUT OF STATE!! That is Obscuration that creates confusion for the consumer..thus never knows IF SHAFTED!! ..
Anyway..My hopes for you American friends is there's SOMETHING put in place to encircle ALL Americans/States to cooperate in order proper HC gets delivered, cost effective..and Customer knowledge...
Many want to complain about the waiting times etc...BUT there are hundreds of millions who already have waiting periods..including VETS..But compare waiting time to NOT HAVING ACCESS at all just because you can't afford it
Medicare for all....fascinating how these discussions assume US doctors are willing to work in such a system. It's much more expensive to become a doctor in the US. Other countries do not require college and they pay for their schooling. More doctors are dropping Medicare every year for a reason...it's charity care. I would worry that Medicare for all would increase the doctor shortage as they leave for other careers. I just dropped Medicare and couldn't be happier.
Medicare for all....fascinating how these discussions assume US doctors are willing to work in such a system. It's much more expensive to become a doctor in the US. Other countries do not require college and they pay for their schooling. More doctors are dropping Medicare every year for a reason...it's charity care. I would worry that Medicare for all would increase the doctor shortage as they leave for other careers. I just dropped Medicare and couldn't be happier.
Quote:
Originally Posted by Ariadne22
Shortage of health care professionals is a common issue - in the US, as well. Medical residency spots are limited and have been for years.
IMO, these two issues above present very viable problems to any National Healthcare initiative.
As Toofache mentions, how do we presume that physicians will participate in these programs? Are we going to force them to? And if so, under what conditions? To dictate to a person with whom they will do business and control their income potential is a wholly un-American ideal, and one that limits their professional opportunities. If we are to dictate their customer base, then we need to offer significant benefits and reduce/eliminate barriers. Benefits? Increase the reimbursement from these government programs to an acceptable level. Subsidize (if not completely pay for) medical education like toofache refers to. Reduce barriers? For one, completely overhaul or eliminate the burdensome malpractice system in this country. This is what physicians in all those countries have. You think the federal and state governments (which are filled with lawyers), are going to now say people are no longer allowed to sue for malpractice? No way.
Ariadne brings up physician training. Another good point. You can't just snap your fingers and increase slots. Increasing residency slots takes time and requires extensive review from Residency Review Committees (RRC's) that are made up of Dept Chairs and Residency Program Directors from other Academic Programs. Programs have to petition for increased slots and then need to be able to demonstrate why those slots are needed and support the fact that they have enough resources to adequately train doctors. There need to be enough practicing faculty to supervise trainees, enough patient load and procedures to go around, enough money for didactic education, research etc etc. Who is going to do all that? Are we also going to force physicians to practice in academics and have to deal with all the BS that goes along with that, which often includes much lower salaries than what's found in private or hospital based practice?
I'm not saying these issues can't be fixed, but it will definitely not happen overnight, and concessions and compromises must (and should) be made, not forcing it down people's throats.
IMO, these two issues above present very viable problems to any National Healthcare initiative.
As Toofache mentions, how do we presume that physicians will participate in these programs? Are we going to force them to? And if so, under what conditions? To dictate to a person with whom they will do business and control their income potential is a wholly un-American ideal, and one that limits their professional opportunities. If we are to dictate their customer base, then we need to offer significant benefits and reduce/eliminate barriers. Benefits? Increase the reimbursement from these government programs to an acceptable level. Subsidize (if not completely pay for) medical education like toofache refers to. Reduce barriers? For one, completely overhaul or eliminate the burdensome malpractice system in this country. This is what physicians in all those countries have. You think the federal and state governments (which are filled with lawyers), are going to now say people are no longer allowed to sue for malpractice? No way.
Ariadne brings up physician training. Another good point. You can't just snap your fingers and increase slots. Increasing residency slots takes time and requires extensive review from Residency Review Committees (RRC's) that are made up of Dept Chairs and Residency Program Directors from other Academic Programs. Programs have to petition for increased slots and then need to be able to demonstrate why those slots are needed and support the fact that they have enough resources to adequately train doctors. There need to be enough practicing faculty to supervise trainees, enough patient load and procedures to go around, enough money for didactic education, research etc etc. Who is going to do all that? Are we also going to force physicians to practice in academics and have to deal with all the BS that goes along with that, which often includes much lower salaries than what's found in private or hospital based practice?
I'm not saying these issues can't be fixed, but it will definitely not happen overnight, and concessions and compromises must (and should) be made, not forcing it down people's throats.
These are issues that have to be worked through. FTR, the United States does not allow slavery. So, no one has any intention of forcing medical professionals to work if they don't want too.
The thought that should occur to anyone though is that everyone has to earn a living. What are the alternatives if health care providers choose to give up medicine? They can take a job in an unrelated field. They can find work in another country--although I doubt they would choose to work in another country with nationalized health care. They can practice and avoid taking the forms of insurance that they don't want to take. The problem with the last alternative is that 90% of all the dollars in health care come from Medicare, Medicaid, other government payment plans, or private insurance. If you want to give up 90% of your potential revenue, you may have a hard time earning a living.
What I suspect we are primarily hearing is simply complaining. Every group in America feels entitled to more than what they are currently getting. That message has come through loud and clear to me. Most people want what they are getting plus another 10%. The problem is that the economic pie doesn't allow for everyone to get another 10% right now because GDP is only growing between 2% to 3% per year.
My solution to the medical provider who doesn't want to take Medicare is "go right ahead". However, I think the public would have every right to say that if you refuse Medicare than you have to forgo your right to participate in every other plan including some well paying ones like "Tricare". We might also want to take a look at prohibiting them from participating in private insurance plans as well. I'm not sure if that could be done, but it might be a possibility.
While I do think the residency training issue has to be looked at I think we should be a bit more liberal in licensing foreign doctors to practice in this country. The testing they have to go through to get a license in the USA is extreme. Some of that is justified, but I also believe there is an element of simply protecting practitioners in our country from competition.
I submit the income of not only physicians, but virtually all medical practitioners is higher than virtually any other profession or occupation. I have a great deal of trouble believing these folks are not making a more than adequate living based on what I observe today and what I have observed over my life.
Medicare for all....fascinating how these discussions assume US doctors are willing to work in such a system. It's much more expensive to become a doctor in the US. Other countries do not require college and they pay for their schooling. More doctors are dropping Medicare every year for a reason...it's charity care. I would worry that Medicare for all would increase the doctor shortage as they leave for other careers. I just dropped Medicare and couldn't be happier.
In the UK it takes about the same time to become a doctor as it does in the US. The UK medical schools don't require a degree for admission to their programs but their admission standards are very high. And, in total, it takes 10+ years before someone meets all the requirements to be a GP. Other specialties take longer than that.
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- unless one is fortunate enough to be covered by a generous employer plan - or POOR enough to get their medical care (with quality as a variable) for almost no cost.
After all, they have no debt and no financial investment.
