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As it is, more and more doctors are leaving their own practice to work for a group that pays them salary rather than dealing with all the headaches and expenses that come with being self employed. If medical providers are going to get paid by all their patients the same amount they get paid now by only their Medicare/Medicaid patients, they're going to have trouble operating and staying in business. They'll have to make huge cuts in expenses, which will include staff. The medical industry is suppose to be expanding because of all the baby boomers that are starting to retire now. How will they be able to do that with what Medicare pays.
The reality is if such a program existed, physicians would stop taking insurance and only take cash particularly specialists. The overwhelming majority of dentists, chiropractors and naturopathic physicians only accept cash yet patients are still willing to see them. Physicians are aware of this and are adopting similar standards. Like dentists, physicians will accept credit cards and place patients on payment plans through third party companies. This is already occuring to some extent. Many physicians particularly in large cities do not accept Medicaid and some don't even take Medicare due to poor reimbursement. Others are moving to a cash based model. People on Medicaid in these cities have a next to impossible time seeing specialists and in some states, they can't even find a single specialist to see them and will have to drive to an adjacent to do so. It's ultimately going to happen. The popular physicians can demand cash for their services and their patients will pay it to be seen by them. In the near future, expect to pay your primary care doctor $100 to $150 cash to see them.
so lets compare costs to something simular in numbers:.......
LOOK at the numbers; look at the cost of our current systems: the more costly medicare; or even the less costly medicaid....go ahead look at the numbers
1. MEDICARE currently covers (only partially, it is not 100% coverage, its a 80/20) about 40 million (about 1/7th of the population) seniors and has an ANNUAL COST of 550 BILLION dollars
2. we spend 320 BILLION dollars on MEDICAID ...to cover (at 100%) about 30 million (most esitmates are between 25 million and 35 million).....
now lets take it further, since some people want a single payer system:
using the medicare numbers..................................to cover all, would cost anywhere from $2.5-4.5 trillion A YEAR..............
using the mediciad numbers..................................transfer that number to 320 million people (our population) the cost would be about 3 TRILLION A YEAR..................
NOW lets look at what the taxpayer would expect to cover the entire population (singlepayer):
divide those numbers (2.5 trillion to 4.5 trillion) by the 120 million taxpayers(according to the IRS)...that's an average tax bill of $20,000-38,000 EACH HOUSEHOLD, EACH YEAR, an always rising.......can you afford that,,, I certainly cant..........and its a HECK OF A LOT MORE THAN PRIVATE INSURANCE. and a heck of a lot especially if you dont go to a docotor but once a year.....is that what they want a once a year doctor bill for $20,000plus
now on the other hand..if we get RID OF INCOME TAX( less than a 1/3 of the country).. and tax EVERYONE on spending (consupmtion)..then EVERYONE CHIPS IN....then we might be able to afford it
Besides, I seem to remember that this country used to be thought of as a"FREE" country where we are FREE to make our own decisions about medical care where our government doesn't FORCE us to do anything provided we don't hurt anyone doing whatever that might be.
To be "thought of" versus the reality can be different things. A parrot in a cage can sing "I'm free" all day long. Having said that, freedom wouldn't require you to be a corporate shill speaking about ills of a government. Freedom would be about your ability to put the right government in place that you don't have to worry about being slaves of corporations either. A government that works for you, not for promoting the corporate agenda.
To be "thought of" versus the reality can be different things. A parrot in a cage can sing "I'm free" all day long. Having said that, freedom wouldn't require you to be a corporate shill speaking about ills of a government. Freedom would be about your ability to put the right government in place that you don't have to worry about being slaves of corporations either. A government that works for you, not for promoting the corporate agenda.
simple solution then
get rid of all private insurance and all government insurance
be free...have the freedom of PERSONAL RESPONSIBILITY
WCH
3 trillion MINUS the amount put in by employers pay for healt insurance = what? (I dont have the number)
As for reducing costs:
1) Any health insurance program SHOULD absolutely have copays and coinsurance. 80/20 should work for hospitalization. Say $25 to see a doctor and $60 to see a specialist. This is one thing many single payer systems get dead wrong. Have a cold? stick it out and go to CVS, that is what it is there for. This is one problem caused by so called gap insurance for medicare patients. They see the doctor because they are lonely. That is what old folks centers are for. Sorry, but highly paid doctorate level people are there to fix technical problems. Unless you fall into the bottom quintile of income, you shall pay something.
2) The McNurse/ Physician assistant/ Walmart Clinic thing (Masters degree level) thing needs to be VASTLY expanded. You do not need a doctor to tell me I have an ear infection, re prescribe me my $4 hypertension wonder drugs that already lowers my BP to 110 /70, my kid has the flu and administer immunizations.
3) Paperwork needs to be standardized across all 50 states and standardized for ?80%? of all medical procedures that are neither life threatening nor complicated.
4) No more 50 page bills for even the longest hospital stay excepting perhaps 2% of them for crazy crazy things. Room charge shall now include unlimited amounts of the bottom ?50%? cost medicines, the tv, water, meals, drinks nurse visits (by room type, I am aware of ICU) etc. Surgery room shall have ?5? different rates includes tools, AND INCLUDES THE FRIGGEN ANESTHESIOLOGIST!!!! No more ridiculous bills for the magically out of network anesthesiologist. The Emergency room charge shall include the use of the E room doctor. Hostpital costs are a game between the insurance industry and hospitals hoping the other can not figure out what the other is doing.
5) Tort reform. Caps on all awards UNLESS found for wanton disregard. NOTE: these are the cases where the doctors credibility and MAYBE HIS LICENSE are called into question. This is ?5%? of cases. IE you go in for a knee surgury and they neuter you. At that point, nuke em! This is a tiny minority.
As for taxes.
End the $800 making work pay for all. ?If necessary increase the lowest end of the EITC *FOR WORKERS WORKING AT LEAST 1500 hours?
Sorry $250K+ goes up to Clinton levels.
MORE importantly.
Carried interest as capital gains is no longer valid. Hedge fund managers get their billions for their labor and if it is not their money in the fund it is income NOT capital gains. This is insanely perverse.
The idea behind capital gains rate is helping employers buy equipment etc thru selling stock. Buying and selling of commodities which only succeeds in making raw materials costs more volatile shall no longer get a preferred tax rate.
WCH
4) No more 50 page bills for even the longest hospital stay excepting perhaps 2% of them for crazy crazy things. Room charge shall now include unlimited amounts of the bottom ?50%? cost medicines, the tv, water, meals, drinks nurse visits (by room type, I am aware of ICU) etc. Surgery room shall have ?5? different rates includes tools, AND INCLUDES THE FRIGGEN ANESTHESIOLOGIST!!!! No more ridiculous bills for the magically out of network anesthesiologist. The Emergency room charge shall include the use of the E room doctor. Hostpital costs are a game between the insurance industry and hospitals hoping the other can not figure out what the other is doing.
you understand when you pay a doctor $100, that its not $100 just going into the doctors pocket
he/she has to pay:
mortgage/rent
office help (nurse/receptionist/billing clerk)
supplies
ELECTRICAL BILL
taxes
you understand the AVERAGE hospital spends 430,000 dollars a MONTH on ELECTRICITY ALONE...that's 5,160,000 (5.1 million) a year just in electric costs...not to mention custodial costs, food costs, laundry costs, sanitation costs, staff costs, etc
.its not about profit (which every business NEEDS to make at least a little, otherwise they will shut thier doors)
you realize how many hospitals have GONE OUT OF BUSINESS because they cant make a profit enough to stay affloat...and the government is a good part of the problem
congress....insurance is illegal
potus...I'll sign
the people...get a bill, pay it
doesnt take a GED to figure it out
Nice! I will vote for you to congress. The problem, I might end up being one of the twenty votes you will get because the populace in general is too stupid to see corporate interests fail in influencing government and its policies. Until then, states like Vermont have the right idea... single payer system.
medicare is an 80/20 and you have to either out of pocket or BUY a private supplemental insurance..it therefore CAN NOT be defined as a singlepayer
Well, if you want to split hairs like that, you're right. But the 80% part is single-payer, and they do it with a much lower overhead than the private insurances.
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