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This is what many Americans do not understand will happen with a single-payer system. I have relatives in other countries who have been denied care because they are too old, in fact they came here and paid their own money to be treated. If I go through the list of older people I know I can count dozens of expensive procedures and surgeries that are considered routine--heart stents, heart valve replacement surgeries, knee replacements, rotator cuff surgeries, diabetes treatments, kidney dialysis,kidney transplant, cancer treatments etc, plus the physical therapies and MRI's, CAT scans that go along with all of those. In a single payer system an uncle who was diagnosed with stage 3 cancer was denied immediate treatment because of his age. Also, with obesity rates skyrocketing I wonder if care will also be rationed along lines of personal-responsibility. Should we pay hundreds of thousands of dollar for surgeries and medications for someone who doesn't exercise and overeats to a point where they are 300 pounds? Will a slim person who exercises and eats right get preferential cancer treatment over another less fit person?Everyone wants these benefits and maybe in theory would be ok with rations until it affected them or someone they loved.
Care to state what countries? I am Canadian, moved to the U.S. to be with my spouse and in all my years of living, including having both parents with chronic life-threatening illnesses care was never denied. As a minister I encounter people from all walks of life and in the hundreds if not thousands of people I have met not one has been denied care. Chemo for someone in their 70's - yup, knee replacement on an obese person - yup, MRI's and CAT scans done the same day they presented themselves to the hospital or doctor complaining of problems - yup. These are examples are from very large cities all the way down to towns of less than 5,000.
The only rationing I have ever encountered and denial of service was when I lived in California and congregants told me their insurance company denied a claim because of X. If they were not wealthy, and most weren't, they received no care which in a couple of cases led to their early death.
^The idea of losing admin level jobs from the private insurance when switching to to single payer is hilarious. You will still need the same level of beaurcracy as private if not more. There would be 0 savings and it wouldn't be free. You would just be taxed more. Yeah health care is free in Europe but you are in a 50% tax bracket. Still paying for it. Nothing the govt does is cheap or efficient. I still dont know why we have a post office anymore.
A couple of facts.
My tax burden in California was greater than my tax burden in Ontario, Canada - income level being the same. What added to the burden in California was the need to pay for a health insurance plan on top of my taxes, not to mention deductibles and co-pays.
Second the doctor I went to in California had 3.5 staffers just for him. They handled appointments, billing, referrals etc. The doctor I went to in Ontario had 2 staffers for 5 physicians.
Contrary to your belief, the bureaucracy decreases drastically with single payer, there is only one company to bill, not the hundreds of plans that must be navigated. The issue of pre-approval is also gone, you need the care, you get it. PERIOD.
"I read that most leave the hospital employ, or at least direct-care floor nursing, by age 40. Of course, I can't find this now. I may have read it in a nursing magazine."
Sadly, it's probably not far from the truth. I know a number of nurses. The older ones I know have either left the floor or are looking forward to leaving it. They are run ragged, sick of being short changed on the floor, while the CEO's rake it in for themselves.
"My tax burden in California was greater than my tax burden in Ontario, Canada - income level being the same."
Thanks much, revrandy. I've heard that hospitals in Canada, for instance, employ only a few people in their accounts receivable department, because there is only one payer. Hospirals in the USA have to employ an army of them to chase down the claims from hundreds of plans and insurers who do not want to pay the bills of their insured. I also know what you mean about prior authorizations and, after having to deal with them during an illness some years ago, can only agree it would be an amazing thing to just go in and get the care...period
.... I've heard that hospitals in Canada, for instance, employ only a few people in their accounts receivable department, because there is only one payer. Hospirals in the USA have to employ an army of them to chase down the claims from hundreds of plans and insurers who do not want to pay the bills of their insured. I also know what you mean about prior authorizations and, after having to deal with them during an illness some years ago, can only agree it would be an amazing thing to just go in and get the care...period
I've read that the overhead for Medicare is just 5% versus 20-30% for the insurance firms who have battalions of clerks looking for ways to deny coverage for a claim. I had a heart test at CSHP back in 2007 while under Kaiser and my doctor, not a nurse or admin type, but my cardiologist had to get on the phone and plead to Kaiser to add one more small test to the overall nuclear stress test process. This is just plain nuts.
I utterly HATE outfits like Kaiser and dumped them after they tried to blackmail CSHP into a 10% across the board cut in payments. CSHP told Kaiser to shove it, so I cancelled Kaiser and went with Blue Cross and stayed with CSHP. I now have Medicare A&B plus the Blue Cross, using CSHP as my docs, and I love it.
I can't wait to get single payer nationwide for all citizens so we can streamline payments and billing. IMO there are massive cost avoidances to be gleaned here and I favor putting those dollars into higher payouts to doctors and hospitals who actually provide medical services to us and not for battalions of back room admin staffers at every hospital, medical practice and legions of insurance firms who are slopping up our health care dollars.
It burns me that first Massachusetts (Romney Care) and now Colorado are forced to step out on their own because our ho-house of a congress is on the take from the insurance industry to maintain the usurious status quo.
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Last edited by Mike from back east; 05-14-2016 at 01:08 PM..
I think an issue you will see if this passes is that employers will add on an additional 10% or whatever for payroll tax. They in theory will be released from providing employee insurance saving them that cost. Individuals will be on the hook for an additional 4% state tax increase and may or may not have health care thats as good as what their company provides. Even if its a savings from not providing health care they won't pass that on to the employee.
Some companies will shut their doors and relocate. Some individuals might pack up. I will be considering it. Im fortunate to live anywhere in my territory and I dont want the govt taking any more out of my pocket and I have excellent insurance.
What will happen is more people that have few skills move to the state for health care that couldn't get it through an employer. With the COL ever increasing in CO, I think long term this could be a bad move for the general population. The super rich can afford to stay and pay the extra cash. Those that are middle to upper middle class will be hurt.
I've read that the overhead for Medicare is just 5% versus 20-30% for the insurance firms who have battalions of clerks looking for ways to deny coverage for a claim. I had a heart test at CSHP back in 2007 while under Kaiser and my doctor, not a nurse or admin type, but my cardiologist had to get on the phone and plead to Kaiser to add one more small test to the overall nuclear stress test process. This is just plain nuts.
I utterly HATE outfits like Kaiser and dumped them after they tried to blackmail CSHP into a 10% across the board cut in payments. CSHP told Kaiser to shove it, so I cancelled Kaiser and went with Blue Cross and stayed with CSHP. I now have Medicare A&B plus the Blue Cross, using CSHP as my docs, and I love it.
I can't wait to get single payer nationwide for all citizens so we can streamline payments and billing. IMO there are massive cost avoidances to be gleaned here and I favor putting those dollars into higher payouts to doctors and hospitals who actually provide medical services to us and not for battalions of back room admin staffers at every hospital, medical practice and legions of insurance firms who are slopping up our health care dollars.
It burns me that first Massachusetts (Romney Care) and now Colorado are forced to step out on their own because our ho-house of a congress is on the take from the insurance industry to maintain the usurious status quo.
Under the ACA private insurance now has to meet a target of no more than 15% for admin. costs for large groups and no more than 20% for others. ObamaCare Rate Review & the 80/20 Rule
Medicare does claim lower admin rates, however, it may be like comparing apples to oranges. I worked for a couple of Medicare-certified home health agencies and I can tell you Medicare is as picky if not pickier than the private insurers. Not that I have any love lost for the insurance companies, either, mind you!
"I've read that the overhead for Medicare is just 5% versus 20-30% for the insurance firms who have battalions of clerks looking for ways to deny coverage for a claim."
Mike, thanks for this, and you are correct. Medicare is about 6% admin costs, while private insurance is about 30%. As Katrina said the The ACA has mandated that insurers now have to devote something like the "80/20" rule. Not only are the insurance company medical directors there to deny as many claims as they can, they employe an army of clerks to look for reasons to deny them and save on what they call "medical losses" -- those who have the bad luck to get sick, they compel providers, hospitals, practices, and so on to employ a near army of billing clerks to wrestle with the insurers for claims. I heard a story that a female physician told once where the insurer wanted her to become the legal guardian of a patient before they would "authorize," a particular medication of that patient.
I have also experienced this. I've had to fight denied claims before, sometimes three or four at the same time. If our legislators had to go through this, we would have universal care in ten minutes.
"It burns me that first Massachusetts (Romney Care) and now Colorado are forced to step out on their own because our ho-house of a congress is on the take from the insurance industry to maintain the usurious status quo."
I agree here. It is ridiculous that states like Massachusetts and now Colorado have to do it alone because our Federal government is so corrupt and on the take from the insurance companies. This is how we ended up with the stupid ACA.
"Some companies will shut their doors and relocate. Some individuals might pack up. I will be considering it. Im fortunate to live anywhere in my territory and I don't want the govt taking any more out of my pocket and I have excellent insurance."
If it is ok to ask, I am curious what kind of insurance you do have. You are one of the lucky ones. For every employee like yourself, five or ten might have insurance so lousy that they cannot use it -- that is, if they have it at all. Why should one employee have better health insurance than another, simply by virtue of employment. At a company I worked at, for example, I had insurance that carried a $5,000 deductible and worked next to a co-worker who had full insurance, without this deductible, simply because our job classifications were different. Is this right?
Also, never forget one thing. This is why I asked what kind of insurance you have now. If this "excellent insurance" is a private policy provided by the company you work for, your company could just as easily take it away. They could go with a new insurer, for example, to cut costs or suddenly decide that they do not want offer that plan you are on to lower their costs. Or they could eliminate your position to save costs and then you would see who would be "taking money out of your pocket" and how much they extract from it if you happened to get sick. I put these out there because I have experienced them first hand. You could be next.
All this chatter about this system, that system, their system, our system, blah, blah, blah. There is only one truth - there is no perfect system. If you accept that simple axiom, then maybe we can find a way to make some improvments. For so many people, it is about power and control (or destruction and chaos), not about improving anything.
What we have in the US healthcare system is a mutt. A non-pedigree system made up of lots of different systems. Just like us. We have private insurance, single payer insurance, hybrid insurance, dog insurance, cat insurance, etc. Stop trying to force people who have chosen their system and are paying for it themselves to also pay for your system. All those who want government health insurance, get a system in place, and you pay the higher taxes (expand Medicare or Medicaid or whatever). All those who want private health insurance, get a system in place, and you pay the higher premiums (private insurance, group insurance, whatever). Stop trying to force one system down all of our throats.
All this chatter, sounds just like the politicians and activists themselves. Little to no mention regarding the effects of US style litigation on health care costs. Do all those other countries have the litigation in their healthcare that we have in ours? Not from what all the foreigners I work with tell me. They cannot believe it. It is crazy. Did Obamacare address this? Well, it was written by, and voted through by a bunch of lawyers, so you figure it out.
Lets' try this. We already have several experiments taking place trying to control costs. Obamacare, Medicare, Medicaid, Romney Care, Oregon Care, soon to be Colorado Care. All about healtcare. None about legal costs. Let's try one that addresses that. Let's assume that doctors, nurses, pharmaceuticals, etc. are actually not trying to harm you, but are genuinely trying to help you and your medical needs, maybe even save your life. Let's assume they are doing their best. Let's assume they are only human. Let's assume you are only human. Let's accept that sometimes, they cannot help you. That you have a bad reaction, or you do not respond to treatment. Let's assume they are really trying. Let's not sue them. That's right. Let's accept sometimes, s*** just happens and itsnobody's fault. How about a system where anyone who joins agrees to never sue for any reason - ever. And health care providers pass on the savings directly to you. I am not suggesting the limited liability crap that some insurance companies have now. But the real deal. No lawsuits. Ever. Let's throw that into the experimental test tube too.
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