Here's Why We Can't Afford Single-Payer (legal, insurance, companies, cost)

[middle-aged mom]

Originally Posted by godofthunder9010

The Affordable Care Act -- which was a pretty obvious stepping stone towards single-payer -- did absolutely nothing to remedy these things. Maybe that's the way the do it in Europe or Canada, but neither party seems to have any interest in actually tackling healthcare price gouging.

I'll have to give Bernie Sanders credit for being an exception. Nobody else brings it up though. One of the biggest reasons: Ambulance chasers are one of the top donors to Democrats. Those poor lawyers need a big piggy bank to raid for their clients. And healthcare special interests donate massive dollars to both sides.

So forgive me if I don't believe that anyone will actually fix anything I've pointed out. They won't.

Something like 56 countries have universal healthcare which is guaranteeing healthcare to all citizens. The US is not one of them. No two countries do universal healthcare the same. Some operate single payer systems. Some totally rely on not for profit private insurer systems. Most are multi payer system.

Some countries require employer contributions and some exclude employers from contributing to the cost of healthcare. All countries subsidize low/ no income people. Countries do not discriminate against those with pre- existing conditions the way most US states allowed insurers to do.

All of these countries have an established baseline of minimum care and rely on MD comprised Compariative- Effectiveness Panels to establish treatment protocols. No reason to prescribe Y medication when X has been deemed to be as effictive and costs less. A similar provision once existed within the initial ACA drafts. Republicans who claimed they did not have an opportunity to read the legislation were able to find the provision and declare it government death panel. The manufacturers of Y medication must have been pleased. The fuss caused this provision to be struck from the final ACA.

All these other countries negotiate the price of medications. Congress twice denied Medicare, the world's largest single payer of medications, the ability to negotiate the cost of medications. And Congress did so at the same time as expanding Medicare to pay for prescription meds. The Big Pharma lobby was tickled pink that Congress was watching out for their best interests more so than the public's interest.

With the exception of NZ, the rest of the world bans direct advertisement of prescription medications to end consumers. Imagine a world where end consumers are not bombarded with ads for medications and encouragement to ask your doctor about drug ABC and then in a lower tone or fine print, let you know that the drug may cause spontaneous diarrhea, organ failure and or death in some users.

Every vote in Congress and state legislates is for sale. Bills typically are stuffed with unrelated pork. Senator blah blah gets a $2 million grant for a donor university to study the effects of nail polish on poodles. A Republican not voting to repeal the ACA for the 50th time will not get party financial support at reelection and be primaried out by someone willing to play the game.

The average senator or house rep, regardless of party, could not spontaneously string together 10 coherent sentences about the ACA or insurance in general.

Germany's universal healthcare system is the world's oldest at 133 years. It has been tweaked annually and periodically reformed since inception. In contrast, our Congress continues to vote to repeal the ACA.

Again, no worries. The 2016 frontrunner promises to replace Obamacare with something wonderful that will take care of everybody and the government will pay for it.

[middle-aged mom]

Originally Posted by Yeledaf

Ah, but the government will have to power to say "This is how much you can charge for x, y, and z. Now deal with it." That's the way it's done in nearly every other country in the world.

Example: I recently spent three years in Japan. Their hospitals are given a list each year by the government which specifies the cost of every medication, procedure, and allied expense. Their hospitals have learned to function within these reasonable constraints. So can ours.

May I add that all countries, including the US, ration healthcare.

Medicare, by law, pays cost, which includes overhead. In competitive healthcare markets, the costs tend to be less than regional markets with limited healthcare.

While most US hospitals are not for profit, they are not precluded from earning profit. Some earn $ hundreds millions in profits each year. They simply cannot use profits to declare dividends for shareholders. Instead, in competitive healthcare markets, those profits are used to build the brand. If you have a serious Cancer diagnosis, do you want to be treated by Sloan Kettering or brand X hospital?

Profits are used to destroy or acquire the competition and medical practices, the pipeline for incoming patients.
Consolidation of hospitals under a common healthcare system can and does eliminate redundant administration and costs. No need for 12 hospitals to operate independent administrative departments for common functions when they can be consolidated and hundreds of full time middle class jobs eliminated.

On the other hand, large healthcare systems that acquire the competition can control the healthcare market.

[Yeledaf]

Originally Posted by middle-aged mom

May I add that all countries, including the US, ration healthcare.

Medicare, by law, pays cost, which includes overhead. In competitive healthcare markets, the costs tend to be less than regional markets with limited healthcare.

While most US hospitals are not for profit, they are not precluded from earning profit. Some earn $ hundreds millions in profits each year. They simply cannot use profits to declare dividends for shareholders. Instead, in competitive healthcare markets, those profits are used to build the brand. If you have a serious Cancer diagnosis, do you want to be treated by Sloan Kettering or brand X hospital?

Profits are used to destroy or acquire the competition and medical practices, the pipeline for incoming patients.
Consolidation of hospitals under a common healthcare system can and does eliminate redundant administration and costs. No need for 12 hospitals to operate independent administrative departments for common functions when they can be consolidated and hundreds of full time middle class jobs eliminated.

On the other hand, large healthcare systems that acquire the competition can control the healthcare market.

Which is precisely what our government needs to do, instead of looking for places to bomb.

[Hoonose]

Originally Posted by godofthunder9010

Single Payer: It's a topic that I'm torn on. On the one hand, it'd surely be nice to just go to the doctor or dentist or optometrist, get done what needs done and not be confronted with a giant medical bill.

But we can't afford it!

It's things like that which make the single-payer system a terrible idea right now.

Take a look at this: 10 Wildly Overinflated Hospital Costs


Because hospitals are doing that sort of thing -- all because "the insurance company or the government will pay for it, so who cares?" -- they make single-payer impossible. And when the most expensive RX's range in cost between $80,300 and $29,800 per month, we can't afford to do a single-payer. (And I thought paying $400 a month out of pocket for Invokana was outrageous!) This was Obama's big blunder. Before doing anything like the ACA, you need to address these problems.

We can't afford single-payer for many reasons, but the single biggest one: Healthcare costs are artificially inflated to such ridiculous levels that we just can't afford it.

We can afford it, as we can always create the needed funds.

But most docs, hospitals and many other entrenched entities like the medical device industry and big pharma won't want to cooperate. (I am a doc, by the way)

We can afford it, but we might not have the necessary future facilities to provide for all the necessary and desired HC if we don't invest properly today. Without enough future docs and other care givers, as well as future HC delivering facilities we would not be able to service everyone.

So again - it is not the money - it is our ability to provide the necessary and desired future HC services that will be our limitation with a universal HC system.

[Yeledaf]

Originally Posted by Hoonose

We can afford it, as we can always create the needed funds.

But most docs, hospitals and many other entrenched entities like the medical device industry and big pharma won't want to cooperate. (I am a doc, by the way)

We can afford it, but we might not have the necessary future facilities to provide for all the necessary and desired HC if we don't invest properly today. Without enough future docs and other care givers, as well as future HC delivering facilities we would not be able to service everyone.

So again - it is not the money - it is our ability to provide the necessary and desired future HC services that will be our limitation with a universal HC system.

We have the ability. What we need is the WILL.

[Hoonose]

Originally Posted by Yeledaf

We have the ability. What we need is the WILL.

I agree that it is only a matter of priorities, not money.

[workingclasshero]

Originally Posted by Hoonose

We can afford it, as we can always create the needed funds.

But most docs, hospitals and many other entrenched entities like the medical device industry and big pharma won't want to cooperate. (I am a doc, by the way)

We can afford it, but we might not have the necessary future facilities to provide for all the necessary and desired HC if we don't invest properly today. Without enough future docs and other care givers, as well as future HC delivering facilities we would not be able to service everyone.

So again - it is not the money - it is our ability to provide the necessary and desired future HC services that will be our limitation with a universal HC system.

we've seen what a 'government option' is like...just look at the dept of health HORROR CLINICS

oh and its NEVER free.... as a taxpayer you cant afford singlepayer



ever worked a budget, or seen what the actual medical costs are???...this is not about insurance..its about actual cost of care

national health care..or singlepayer..or universal health care...cant be done without killing the taxpayer

national health care or mediciad for all.. or whatever you want to call it will cost 3 trillion to 6 trillion YEARLY and ALWAYS going up

there are only 140 million tax FILERS of which 47% dont pay anything or nearly nothing...so there are only about 70-75 million tax PAYERS

are you a taxpayer....then you wont be able to afford medicare for all (which is NOT a 100% singlepayer( it is a 80/20 insurance)


we've seen what a 'government option' is like...just look at the dept of health HORROR CLINICS

oh and its NEVER free.... as a taxpayer you cant afford singlepayer

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singlepayer wont save you a dime.... but if you are a taxpayer you sure will be screwed

if the payer (government in this case) says the payment is xxx, yet the provider NEEDS yyy to cover all his over head, then its not just about a payment...we have many (some say as many as 1500) cost of living areas within the usa.... that's one of the key things to remember is that one size does not fit all


with UHC you cant GUARENTEE of QUALITY care (look at the health dept horror clinics)

you (the taxpayer) cant afford singlepayer aka uhc....unless we change the tax system

singlepayer ( total government funding(taxpayer) and total government control) is NOT what we need...not if we EXPECT the QUALITY of care

when you look at the COSTS of ACTUAL care (not insurance) and the OVERHEAD costs associated with the care..the cost would be astronomical to cover 320 million people

and lets look at the some other numbers:

the ACTUAL cost just to help americans with Alzheimer's is over 300 billion every year

and let's not forget:

Obesity rates among ALL OECD nations increased in recent years, with the highest rate in the U.S. at 34.3% -- which means one in 3 Americans is by definition obese.----costing 250 billion per year and will grow to 344 billion within the next 2 years
New Data Shows Obesity Costs Will Grow to $344 Billion by 2018 | Partnership to Fight Chronic Disease


number of americans getting cancer (new cases) per year 1.8 million for a total of 19 million people being treated (fighting) each year...each year at least 570,000 die from cancer....the cost is over 100 billion. and expected to be 158 billion by 2020



number of americans with heart disease: 26.2 million and of those..((Number of visits with heart disease as primary diagnosis: 16 million ))((Number of discharges with heart disease as first-listed diagnosis: 4.2 million)).....800,000 people in the USA die from heart disease annually....the cost 440 billionannualy



number of americans in full pledged nursing homes: 2 million...... the average cost Adult Day Health Care,.18,000 per year......assisted living facility 43,000 per year....nursing home (semi-private room),.80,000 per year.......nursing home (private room),.91,000
number of americans in all levels of nursing homes and assisted living....11 million (Annually 10,995,100 people receive support from the 5 main long-term care service; home health agencies (5,742,500), nursing homes (2,383,700), hospices (1,544,500), residential care communities (913,300) and adult day service centers (373,200)...............total cost of long term care 450 billion annually...and going up every year
https://www.genworth.com/corporate/a...t-of-care.html





More than 25 million Americans have significant vision loss.((a total of 80 million Americans have potentially blinding eye diseases. )) (((hmmm more than 25 million americans are blind or going blind.....that's more than Norway, Finland, Denmark, Switzerland, and Austria COMBINED TOTAL population....)))......The cost of vision loss, including direct costs and lost productivity, is estimated to exceed $139 billion
Cost of Vision Problems — Discussion


number of americans with diabetes: 29 million....total cost 295 billion per year


number of americans with asthma: 26 million....Each day 11 Americans die from asthma.......annual costs 66 billion per yearand increasing


while some of those may overlap...look at those numbers that's over 150 million with MAJOR health problem,,costly problems......we will ALWAYS be the largest spender in the world...we have the 3rd highest population in the world (next to china and India) and we have more people (total, not a percentage) with major problems than any other country in Europe.....I just showed you at least 150 million people with cancer, heart, blindness, diabetes, asthma.......that's more than France and great Britain COMBINED for their total populations.




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so what are we saying we should FORCE doctors and nurse to work for minimum wage. and have offices in huts

when you pay that doctor $100 ,, its not 100 dollars going into his pocket...there are lots of other COSTS

how are you going to control the cost of medical equipment(mri or x-ray machines, etc)??????most xray machine are made in Denmark

how are you going to control the cost of the rising electric bills the doctors/hospitals are facing????

how are you going to control the rising property tax/rent/mortgage that doctors face?????

how are you going to control the cost of supplies(gauze, plaster, silk, rubber, polystyrene( a oil product)?????especially some supplies that aren't even american

how are you going to control the cost of people salaries???? a maximum wage???

how they are going to control the employment costs for Doctors, nurses, technicians, hospital food operators, hospital linen cleaning service, custodial services, medical transcribers........are you going to 'nationalize' every profession that is even remotely connected to medicine????

how are they going to control malpractice INSURANCE COSTS?????

things are expensive

for example the average hospital uses a lot of electricity...about 400,000 a month...thats 5 million dollars in electric costs yearly.....you are not going to cut that piece of overhead

when you go to the local doctor and pay him/her 100..its not 100 going into their pocket

they have lots of overhead costs:
rent/lease/mortgage
property taxes
electric costs
equipment costs(and many pieces of equipment are not even made here)
cleaning costs
supply costs
personnel costs
etc


singlepayer will not control these costs


don't you get it... medicine (like anyother SERVICE) costs money,,(,money that our government doesn't have)

want to know A BIG REASON why its lower in those other countries.??? salaries.....a nurse in France(actually most of europe) makes about 1500-1800 a month(in us dollars)..that's 18-20000 a year.....meanwhile according to payscale.com the average Rn makes 40-78,000 in the usa


is that what you want??? do you want to have medical PROFESSIONALS be forced to work for nearly minimum wage



.............I and most people (to include republicans) would be all for single payer...except for two things that the "pro singlepayer" people cant answer.......

1. it wouldn't be like the CRAPCARE of the health department clinics (death traps), I want a GUARENTEE of QUALITY care (not health dept horror clinics)...
2. and there was a fair way of funding it......replacing the personal income tax, the estate tax, the corporate tax with the fair tax (a consumption tax) is about the only way to fund it...but the liberals will never go for it...their ansewr is MORE taxes on the middleclass

if you are a taxpayer...you cant afford singlepayer

[middle-aged mom]

Originally Posted by cisco kid

There is nothing in the ACA or Obamacare that gets us remotely close to single-payer.
Obamacare forces everyone to pay into the middle-man known as for-profit private insurance, which raises costs greatly because they are in business to maximize profit at your expense. OTOH single-payer eliminates the private insurance middle-man altogether. Single-payer would simply be an expansion of Medicare that is accessible to everyone.

In many ways Obamacare is worse than what we had before.

Prior to the ACA, the profits of healthcare insurers were not capped.

The ACA caps insurers' profits. Beginning in 2011, insurers were required to rebate $1.1 billion and rebates have continued ever since.

Makes one wonder how much legislative push back is motivated by the insurance lobby and political donations.

In April, the ACA will be 6 years old. No alternative has gained traction in Congress.

When I hear of yet another vote to repeal the ACA I hear lobbies, Big Pharm, AHA insurers, medical devise manufacturers etc, loud and clear. Several of these sectors provide their investors with the largest returns on their investments, compared to non healthcare related sectors.

While the rest of the developed world annually tweaks and periodically reforms their healthcare systems, the US remains stuck.

What's missing in all international healthcare schemes is a focus on personal responsibility. With 70% of all adults being overweight/ obese we are substantially more vulnerable to Heart Disease, High Blood Pressure, Stroke, Diabetes and related maladies and some Cancers. If half of the population got their waist sizes in the normal range, the cost of healthcare would significantly decrease.

No reason why those who choose to not control their waist size should pay the same premium as, taking it to an extreme, a star of " My 600-700 pound life". No reason why anyone who chooses to not control their waist size should be eligible for subsidy or Medicaid or EMTLA.

Controlling one's own risk factors will do more to reduce the cost of healthcare than anything else.

[middle-aged mom]

Originally Posted by stburr91

Why didn't the Democrats create a single payer system instead of Obamacare?

It was tough enough to get Democrats to support ACA, let alone single payer.

Big Pharm, big hospital, big insurance, big medical devise manufacturing are non- partisan lobbyists and donors.

[middle-aged mom]

Originally Posted by cisco kid

Most of them including Obama receive large monetary 'contributions' from the insurance industry.
In other countries that would be known as corruption.

Originally Posted by Yeledaf

To be fair, the GOP picks up a little spare change from that source, as well.

As is the case with most issues, both houses deserve a pox.

A little spare change?

Lobbyists are non- partisan.