How can the US afford a single-payer system? (generation, drugs, regular)
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No more peculiar than people using derogatory comparisons to "socialized", "single-payer" or "universal" about which they know nothing beyond whatever indoctrination they've gotten for decades from big pharma and insurance companies.
And the politicians and media in the pocket of Big Pharm and the American Hospital Association.
We currently have a single-payer system for the elderly: I believe all people aged 65 and older are eligible. I believe Medicare/Medicaid spends around $900 billion a year, if I am not mistaken, for 45 million people (elderly and disabled). Curious how much the number balloons when 300 million people are thrown on it.
Oh, there are ways a single-payer plan could be affordable for the country. Either charge premiums by the pound, or use much stricter rationing--as is the case in the rest of the developed world. No more blank check six-figure surgeries for people above age 70, for example.
A single payor model will require some rationing (the word that leaves a bad taste in everyone's mouth). The government cannot print money fast enough to pay for the medical care in the country that the entire population wants.
That means that we fund (with a tax) coverage that will meet the needs of most of the country and subsidize the cost for those who cannot pay. If people want coverage beyond what is in the basket of "needs", they can buy additional coverage. Of course, the sticking point will be what that basket contains. When this was discussed before, the accusations of "killing grandma" flew. I do not see it that way. We spend a great deal, often at the end of life, on treatments that are futile and often only delay death by a very short length of time. Someone should not be able to demand that all the stops be pulled out for grandma when there is no hope for a meaningful recovery - unless someone other than the tax supported system is going to pay. I say that as one who is a grandma herself. There should be an option for buying extra coverage (similar to Medicare supplements), paid for with your own money, to cover "wants" that are not in the needs basket: dental, vision, infertility treatment, elective surgery, a private hospital room.
It is not necessary to give everyone in the country "the best coverage currently available." It is necessary to provide everyone with adequate care.
There is waste in the current system that can be removed, too, starting with cutting out advertising by doctors and hospitals and the onerous pre-authorization procedures that waste physician time. Cutting out the inefficiencies in the current claims process would be a big help, too.
All healthcare is rationed. In the US rationing occurs via insurance, insured vs uninsured. Before the ACA, that included the under insured.
Try walking into a Cancer Treatment facility without insurance or the ability to pay out of pocket upfront and you are declined- your ration is none.
Consider the current health insurance companies: Blue Cross & Blue Shield, Harvard Pilgrim, United Health Care, etc. All of these companies have huge overhead, and executives that make millions. If all these fees, salaries, and bonuses are eliminated, of course it would be better. These companies are nothing but the middle man earning a considerable profit. If all these companies are cut out, and everyone is on the same page, with the same benefit options it would improve the costs, and probably the quality of health care as well, along with less confusion. Forget the idea that having numerous companies create competition; these companies all work in collusion, with benefits that get worse and worse for the consumer each year.
I think there will be a future trend towards hospitals writing their own insurance and minimizing the middleman.
just as government schools are dumbed down so everyone can get the same education, so will health care be bastardized to give everyone " adequate care" ( whatever that highly flexible term implies)
Oh c'mon here, the health care could just as possibly improve which would not be difficult to imagine if you weren't so indoctrinated with bullcrap.
Third largest killer .....mmmm; one could argue very effectively that healthcare in America has already been bastardized to the point of it being downright dangerous as well as exorbitantly expensive beyond all reason.
Now factor in this little canard and what do you have?
Removing the profit making motive for hospitals and doctors to screw up your surgery would be a place to start wouldn't you agree?
This is of course, probably not a problem for those who are rich and can afford to sue, with the hospital and doctors knowing this before they make that first cut, eh?
That's some stellar system alrighty!
You keep your system and the rest of us will more than gladly keep ours.
The same way it affords its stupid, bloated military.
The Federal government issues an order to the bank to increase the value in the accounts of our armed forces personnel. Poof!
I dont think anyone takes you seriously anymore
Quote:
Originally Posted by greywar
I understand the difference between billed and paid just fine. I also understand that the PAID part is vastly higher in the US then elsewhere, while the billed is even worse.
And what dont I want to discuss that hasnt been refuted already?
If the government is underpaying their claims, what do you think will happen when everyone gets on a government program and the hospitals get underpaid for everything?
If the government is underpaying their claims, what do you think will happen when everyone gets on a government program and the hospitals get underpaid for everything?
Please. you make an assertion that has no basis in reality.
Tell me, which would you prefer? $100 from the government, or $120 from a insurance company? Given the MASSIVE paperwork from the insurance company, that will deny half of it, and force you through hoops for the other half....take the government money.
Other countries with universal healthcare, not necessarily single- payer, have government controls over pricing. The state negotiates the price of prescription medications. They are not popping $100,000+!for a single round of Cancer Treatment as is common in the US. Hospitals trend true non profit. Making $ hundreds of millions a year in profit in unheard of. Having bloated non medical admin staffs is unheard of.
The Swiss have universial healthcare and requires everyone to maintain private healthcare insurance. The government subsidizes 40% of premiums. The premiums for all adults are the same and more affordable. The Swiss government owns and operates most hospitals and manages costs.
People are not dying in the streets.
I've always assumed the Swiss system (really, the Swiss canton system I guess) made a certain amount of sense, but all I've seen about it is half page write-ups. It's probably worth a 500 page book with a bit of detail to see what's what.
In theory, I like the idea of lifting an entire health construction since I'm utterly unconvinced that a bunch of Harvard-trained bureaucrats (choose yer poison here) are capable of building complex systems from first principles. It's just not in the cards. Real deal national health systems were pieced together through evolutionary steps....in a sense perhaps the ACA is that, but it's certainly a clumsy attempt.
In the case of the US, anything the Swiss might do is probably out of the picture due to cultural and demographic differences. I bet that their system largely depends on the Swiss people as an important component. Culture will begat public policy, not the opposite.
If the government is underpaying their claims, what do you think will happen when everyone gets on a government program and the hospitals get underpaid for everything?
A black hole and then the world ends. You're pitting a local monopoly (often) against a monopsony.
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