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There is no getting around it; single payer national health schemes are expensive. As a result you find taxes and other revenue streams higher in countries with such plans than say the USA.
Right away some will chime in "oh my income taxes in "X" country are less than most in America for the same bracket, but remember this; VAT. Value added taxes along with a host of other "use" taxes are piled on top of income taxes. So no you may not have money taken out of your paycheck, but never the less it is coming out of your wallet/purse one way or another.
When you get down to the nitty-gritty residents of UK, France, Belgium, etc.. all countries with a universal healthcare scheme though may gripe about the taxes, support the system and underlying idea; that all persons should have access to a base level of quality healthcare regardless of income (or not).
No such enlightenment washes over a bulk of the USA population. The Protestant Work Ethic that this country was built upon tells us that these things should be up to individuals to sort out. If you cannot afford healthcare then *you* should look to your life and sort out why that isn't so. While perhaps some charity should be given on no account should there be luxuries or indulgences. No IVF, gender reassignment, etc.... It is another variation of "you can help yourself but don't you take too much".
On a state level only very wealthy ones like perhaps New York, California and so forth might make success of universal healthcare state wide. These would also have to be largely Democratic/progressive states as well.
Health care has to be paid for. You either pay for it through insurance or through taxes. Health care in the USA costs a lot more than in any other developed country. We need to be figuring out how to get the per-capita cost down at least to the level of a Switzerland or Germany (both who have an insurance model).
Our government is very efficient at collecting taxes, except from folks able to cheat their way out, and spending money, ask any military contractor, so the government serving as an insurance company would cost far less than a privately owned system. Just the savings in executive salaries, office space and dividends would pay for most of the system. In addition the government would negotiate prices so $500 a shot medicines would not happen as well as overpaid hospital and drug company executives. As a single payer the government could crush the waste out of the health providers.
It seems we pay about 20% of the overall economy for health care. OK so let the government collect that, preferably with a progressive income tax with a very high deductible, and pay for the care instead of out current system that denies care based on ability to pay.
Health care has to be paid for. You either pay for it through insurance or through taxes. Health care in the USA costs a lot more than in any other developed country. We need to be figuring out how to get the per-capita cost down at least to the level of a Switzerland or Germany (both who have an insurance model).
It is the inefficiency and fraud endorsed by fedral agencies that keep healthcare costs high. Add in the lack of cross state border competetion mandated by law. Invite the government into healthcare in the USA is a death sentence.
CH and Germany are essentially 'little towns' which are easier to control and track funds. Like telling the nation composed of 50 euro countries that they need to control finances just like your family of four does.
Great theory fails in application.
Imagine just 90 individuals generated 260 mill on fraud!
"Medicare Fraud Strike Force Charges 90 Individuals for Approximately $260 million in False Billing"
and medicare and medicaid fraud.... "Medicare and Medicaid
Fraud in the two main federal health programs is huge, imposing costs on taxpayers at least in the tens of billions of dollars each year. As broad-based government programs, the massive size of Medicare and Medicaid makes them very difficult to police. Medicare, for example, processes 1.2 billion claims each year by computer, generally without human eyes checking them for accuracy."
As an American living in the UK and covered by the National Health Service, too bad.
I would pay higher taxes for single payer in the US.
And likewise, you would condemn everyone else to do the same. That's the main problem I have with those who share your philosophy. Do as I do. Think as I think. Sorry, but that does not work for all of us.
It is the inefficiency and fraud endorsed by fedral agencies that keep healthcare costs high. Add in the lack of cross state border competetion mandated by law. Invite the government into healthcare in the USA is a death sentence.
CH and Germany are essentially 'little towns' which are easier to control and track funds. Like telling the nation composed of 50 euro countries that they need to control finances just like your family of four does.
Great theory fails in application.
Imagine just 90 individuals generated 260 mill on fraud!
"Medicare Fraud Strike Force Charges 90 Individuals for Approximately $260 million in False Billing"
and medicare and medicaid fraud.... "Medicare and Medicaid
Fraud in the two main federal health programs is huge, imposing costs on taxpayers at least in the tens of billions of dollars each year. As broad-based government programs, the massive size of Medicare and Medicaid makes them very difficult to police. Medicare, for example, processes 1.2 billion claims each year by computer, generally without human eyes checking them for accuracy."
I don't really care what system I use for health care (Single Payer, insurance, etc.) so long as I get good quality care for a reasonable price. So what is your practical solution for getting health care costs down?
I don't really care what system I use for health care (Single Payer, insurance, etc.) so long as I get good quality care for a reasonable price. So what is your practical solution for getting health care costs down?
I'd like to see us move toward a Medicare type plan that is available to younger people. That's single payer but it can be an effective way to go so long as you contain costs. People should also have the choice to opt out and buy their own coverage if they want (as they do with current Medicare). Allow young healthy people to do catastrophic coverage with HSA's if they wish.
The two key factors are (a) eliminate waste and duplication and (b) leverage the plan to control the costs of Big Pharma, the huge hospital and supply chains, etc.
Our government is very efficient at collecting taxes, except from folks able to cheat their way out, and spending money, ask any military contractor, so the government serving as an insurance company would cost far less than a privately owned system. Just the savings in executive salaries, office space and dividends would pay for most of the system. In addition the government would negotiate prices so $500 a shot medicines would not happen as well as overpaid hospital and drug company executives. As a single payer the government could crush the waste out of the health providers.
It seems we pay about 20% of the overall economy for health care. OK so let the government collect that, preferably with a progressive income tax with a very high deductible, and pay for the care instead of out current system that denies care based on ability to pay.
Hillarious.
Toilet seats cost the DOD over $500. Those $500/shot medicines would double in cost if the government took over.
And who do you think will be processing the claims? Insurance companies, that's who. None would go out of business and the costs would increase.
The ACA is garbage. Instead, what our federal government could do is give incentives for more students to go into medicine and to make their tuition costs lower. We are going to have a shortage of doctors in the future. We also need to lower the actual costs of medical treatments. It's not about having everyone covered by health insurance, but more that regular checkups and maintenances like mammograms, prenatal care and colonoscopies should be affordable in an out of pocket way. Health insurance should be more used for catastrophic medical situations like emergency care and serious illnesses like cancer. And the costs of prescription medicines should also be regulated.
I have no problems with the wealthy being able to afford better doctors or more care. The poorer folk just need to be able to get the minimal basics whatever standard that society wants to set for them. And they can create a crowd sourcing request like with gofundme for any special needs.
To me, this is a shame, but it was kind of inevitable. I think this shows why a state-by-state approach is not going to work. We need to do the entire country at once.
I see it as this shows that a single-payer system is unlikely because it would be expensive as hell.
If Vermont -- the 49th least populous state out of 50, or in Obama's world, the 56th least populated state out of 57 -- cannot make this fly, then it is not likely to happen in a country of 320 million people.
Vermont was proposing 21% in NEW taxes, and they knew that wouldn't be enough, which is why the idea is dead. The reality is that the actual number would have probably needed to have been closer to 28%, which is ON TOP OF a state income tax that can reach 9%, to say nothing of the federal tax those people have to pay.
What was a shame is the fact that the governor failed to discuss the costs UP FRONT before deciding to proceed. Had he floated the "real" tax increases up front, he would have likely been burned at the stake.
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