Why doesn't America have universal health care? (voted, Colorado, cities)
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
and the 50 states (actually 51, as you have to count DC) also have Medicaid
and Medicaid/medicare are killers to the federal budget
2017 medicare was 691 billion (covering at 80/20 about 46 million people)...….prediction for 2020....963 billion......prediction for 2026....1.383 Trillion
actual Medicaid 2017 368 billion (covering about 40 million, mostly kids)......prediction for 2020....450 billion......prediction for 2026....616 Billion
nearly a trillion dollars fy17 (and only covering 29% of the population).....and a predicted 2 trillion by 2026
Nothing much more important than national defense and health. It's hard to predict our future defense needs and costs, but with HC we are assured of continued increases moving forward. And that will necessarily mean more new money creation, that can only happen at the federal level. In 10, 20 and maybe 50 years some of us will still be on this forum discussing these same topics, wondering how we will manage it in 100 years.
Nothing much more important than national defense and health. It's hard to predict our future defense needs and costs, but with HC we are assured of continued increases moving forward. And that will necessarily mean more new money creation, that can only happen at the federal level. In 10, 20 and maybe 50 years some of us will still be on this forum discussing these same topics, wondering how we will manage it in 100 years.
Thevfirst thing to do to lower medical costs is to cap the pay of doctors.
How big of a house and how many cars do they need?
Teachers and firefighters are just as important, and they aren't living in gated communities and flyingvto Europe for ski vacations.
Thevfirst thing to do to lower medical costs is to cap the pay of doctors.
How big of a house and how many cars do they need?
Teachers and firefighters are just as important, and they aren't living in gated communities and flyingvto Europe for ski vacations.
Or we could start by simply taking away the market manipulation of the true elites. Most doctors are merely wealthy but are not nearly elite. Elites control congress with their $ hundreds of millions +++.
There is NO reason that the US govt should be prohibited from negotiating drug prices.
There is NO reason the US consumer should pay 2X to 10X for a drug that someone in EVERY OTHER country pays.
There is NO reason to allow monopolies to continue fixing prices
There is NO reason to allow opaque pricing in everything medical
There is NO reason to require certificates of need.
We could START there. Of course it will NEVER happen since the true elite own congress.
Thevfirst thing to do to lower medical costs is to cap the pay of doctors.
How big of a house and how many cars do they need?
Teachers and firefighters are just as important, and they aren't living in gated communities and flyingvto Europe for ski vacations.
Capping docs pay will only have a small effect. Depending on the type of doc, how and where they practice, the doc's salary is but a small part of the overall HC dollars he or she directs/controls on behalf of the patients. And an even smaller portion of overall HC costs.
I agree with you about teachers and firefighters. But if I were King I'd do it differently. I'd award them in some manner with cars and trips.
Capping docs pay will only have a small effect. Depending on the type of doc, how and where they practice, the doc's salary is but a small part of the overall HC dollars he or she directs/controls on behalf of the patients. And an even smaller portion of overall HC costs.
I agree with you about teachers and firefighters. But if I were King I'd do it differently. I'd award them in some manner with cars and trips.
Capping doctor pay was sarcasm.
My bad for not doing an emoji or something to indicate my intent.
Where do you get that number? It would mean we spend $15K per year, per person. And we don't (yet).
One has to be careful and separate HC billings, costs and moneys actually paid.
For instance hospitals actually collect about 25% of total billings.
Actual costs would be more difficult to pin down. But probably on the order of 20% of total billings.
number of Americans in full pledged nursinghomes: 2.5 million...... the average cost Adult Day Health Care,.20,000 per year......assisted living facility 45,000 per year....nursing home (semi-private room),.85,000 per year.......nursing home (private room),.96,000
number of americans in all levels of nursinghomes and assisted living....12 million (Annually)... 11,995,100 people receive support from the 5 main long-term care service; home health agencies (5,742,500), nursinghomes (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 590 billion annually...and going up every year https://www.genworth.com/corporate/a...t-of-care.html
will nursing homes be covered under a singlepayer...or would that massive expense be classified as ''not covered''?? or is that nearly trillion dollar bill right back on the peoples back??
----------------------------
More than 26 million Americans have significant vision loss.((a total of 85 million Americans have potentially blinding eye diseases. )) (((hmmm more than 26 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 $141 billion in 2017
----------------------------
number of Americans with heart disease: 29.2 million and of those..((Number of visits with heart disease as primary diagnosis: 17 million ))((Number of discharges with heart disease as first-listed diagnosis: 4.9 million)).....900,000 people in the USA die from heart disease annually....the cost 690 billion annually
will cardiac care be covered under a singlepayer...or would that massive expense be classified as ''not covered'' or "sorry you smoke, or eat too much" not covered?? that is the cost of CARE... again has nothing to do with insurance
---------------------------------
number of Americans with diabetes below the age of 60: 31 million....total cost 395 billion per year, and rising.....
will the ''government single-payer'' say.... nope, you got diabetes, because you are FAT, sorry not covered??
Obesity rates among ALL OECD nations increased in recent years, with the highest rate in the U.S. at 37.3% -- which means one in 3 Americans is by definition obese.----366 billion per year year
New Data Shows Obesity Costs Will Grow to $444 Billion by 2020 | Partnership to Fight Chronic Disease http://www.fightchronicdisease.org/m...4-billion-2018
-----------------------------------------------------
number of Americans getting cancer (new cases) per year 1.9 million for a total of 25 million people being treated (fighting) each year...each year at least 570,000 die from cancer....the cost is over 250 billion. and expected to be 290 billion by 2020
---------------------------------------------
number of Americans with asthma: 27 million....Each day 11 Americans die from asthma.......annual costs 76 billion per year and increasing
that's over 130 million people with serious health risks..while some may overlap..its still a good one third of the country..and that right there is 2.6 trillion dollars (590b + 141B + 690b + 395b + 444b + 290b + 76b = 2.626 trillion)
that is 2.6 trillion on serious health risks.... now add in all normal visits, specialty visits, labs, knee/hip/rotator cuff/back surgeries ..........easily hit 5t to even 6t in actual CARE costs ......
Quote:
this is from back in 09...
Approximately 6% of US adults reported an ambulatory visit for a primary diagnosis of a back or neck condition (13.6 million in 2008). Between 49% and 70% of all adults will experience a back pain episode during their lifetime, and, at any given point in time, 12% to 30% of adults have an active back problem. Estimates of the total expenditures on care is that approximately $90 billion is spent on the diagnosis and management of low back pain, and an additional $10 to $20 billion is attributed to economic losses in productivity each year. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3423501/
number of Americans in full pledged nursinghomes: 2.5 million...... the average cost Adult Day Health Care,.20,000 per year......assisted living facility 45,000 per year....nursing home (semi-private room),.85,000 per year.......nursing home (private room),.96,000
number of americans in all levels of nursinghomes and assisted living....12 million (Annually)... 11,995,100 people receive support from the 5 main long-term care service; home health agencies (5,742,500), nursinghomes (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 590 billion annually...and going up every year https://www.genworth.com/corporate/a...t-of-care.html
will nursing homes be covered under a singlepayer...or would that massive expense be classified as ''not covered''?? or is that nearly trillion dollar bill right back on the peoples back??
----------------------------
More than 26 million Americans have significant vision loss.((a total of 85 million Americans have potentially blinding eye diseases. )) (((hmmm more than 26 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 $141 billion in 2017
----------------------------
number of Americans with heart disease: 29.2 million and of those..((Number of visits with heart disease as primary diagnosis: 17 million ))((Number of discharges with heart disease as first-listed diagnosis: 4.9 million)).....900,000 people in the USA die from heart disease annually....the cost 690 billion annually
will cardiac care be covered under a singlepayer...or would that massive expense be classified as ''not covered'' or "sorry you smoke, or eat too much" not covered?? that is the cost of CARE... again has nothing to do with insurance
---------------------------------
number of Americans with diabetes below the age of 60: 31 million....total cost 395 billion per year, and rising.....
will the ''government single-payer'' say.... nope, you got diabetes, because you are FAT, sorry not covered??
Obesity rates among ALL OECD nations increased in recent years, with the highest rate in the U.S. at 37.3% -- which means one in 3 Americans is by definition obese.----366 billion per year year
New Data Shows Obesity Costs Will Grow to $444 Billion by 2020 | Partnership to Fight Chronic Disease http://www.fightchronicdisease.org/m...4-billion-2018
-----------------------------------------------------
number of Americans getting cancer (new cases) per year 1.9 million for a total of 25 million people being treated (fighting) each year...each year at least 570,000 die from cancer....the cost is over 250 billion. and expected to be 290 billion by 2020
---------------------------------------------
number of Americans with asthma: 27 million....Each day 11 Americans die from asthma.......annual costs 76 billion per year and increasing
that's over 130 million people with serious health risks..while some may overlap..its still a good one third of the country..and that right there is 2.6 trillion dollars (590b + 141B + 690b + 395b + 444b + 290b + 76b = 2.626 trillion)
that is 2.6 trillion on serious health risks.... now add in all normal visits, specialty visits, labs, knee/hip/rotator cuff/back surgeries ..........easily hit 5t to even 6t in actual CARE costs ......
Medicare, Medicaids and Obamacare pay for skilled nursing, rehab care, home health and hospice care for some extended time. Usually after a hospitalization.
Custodial care in nursing homes most likely will not be covered.
Diabetes, blindness, cardiac, asthma, obesity, no reason they won't continue to be covered.
cost of actual CARE...not insurance, but the nuts and bolts of actual care....over 5 trillion a year
under M4A/singlepayer/UHC the employer contribution goes away...laying those costs squarely on the minority of taxpayers
while I don't care for HC being employer sponsored (ties people to a job)..I certainly don't want to see the 80 million taxpayers get soaked with a 50K bill
If people and politicians "think" the M4A will do wonders, cut costs, and have unicorns dancing in the streets...then why not do it in steps
there is no guarantee M4A could lower any costs or overhead
it will cost an additional 4.1 trillion yearly (according to the CBO)..even Bernie said an ADDITIONAL 4.1 trillion to our budget...and increasing yearly with inflation
with all the denial of service that medicare has...with the staggering cost to the taxpayer
why not take it in steps
why go for mount Everest, when you can do the Rockies first
what we could do is... revise the current medicare and SS systems...yes we could do that
how about (assuming passing this idea into law in 2020) lower the age for medicare to 60 starting 2020...…....(as most who want to retire don't because medicare is stuck at 65) adjust the cost factor (payroll tax) by 1% (1% is not going to hurt many peoples take home)...revise the formulary so there are less denials of service (too include knee and spinal disc replacements that currently medicare denies because the person is "too old"))....then analyze the cost before next step of lowering to 55 in ten years..then also increase the payroll tax from the new 2% to 2.5% or 3%...(based on the analysis of cost). revise the medicare benefit chart so doctors get their fair share, and so patients get less denial of care
take SS raise the FULL retirement age to 72, (prorated as) those entering the workforce (turning 18) in 2020 FRA is 68..those entering the workforce in 2026 is 69...entering 2032 is 70...etc 6 year steps
raise payroll from 6.2% to 7%...lower the reduced age of retirement (currently 62) to match the new eligibility age for medicare
this would fix the problem of people still working at 55/60 because of health ins...they would retire if they could get medicare….this would also get you a better idea of the overall cost to revise it even more in the future
it makes more sense than to abolish "private insurance" and shoot your whole load on a pipe dream, especially with politicians like Warren not even wanting to admit that the middleclass WILL see a big tax increase
----edit for additional thought-----
OR...another avenue of approach could be UBI...
The concept of UBI is certainly a nice thing....and it is certainly the smartest, most logical of all the wild ideas of the fascist liberals
for example:
I work, have a wife, and my daughter turns 18 (still in high school) next month
and even though I make 70k/yr a extra 3k/month (3 people over 18 in the household) would be a great thing......especially if it is like welfare (not taxed)
and it answers the problem of affordable medical care..affordable education...affordable childcare...and student loans debts...…...how you say?
well let's look at a example...
I work, have a wife, 4 kids and my oldest daughter turns 18 (still in high school) next month and even though I make 70k/yr...……..
UBI would be an extra 3k/month (3 people over 18 in the household)……….
that's 1k for my daughter PER MONTH for college (local CC is offering 500 per semester)
that's 1k for daycare/school activities/wife's student loan PER MONTH
and 1k more for a health insurance Cadillac plan (I pay 600/month) so that takes care of my family premium
imagine that...UBI out does bernies/beth/Harris's plans of M4A/free college/free daycare/studentloan payoff
the problem with UBI is currently the math on how to pay for it..... it is off by a little....
there are 257 million people in the USA over 18
if we "give" $1000/month to each of those 257 million , that is 257 billion monthly, or 3.08 trillion annually
yang's idea of a 10% VAT will earn about 900 billion.... so that is a 2.184 trillion deficit....
that 2.184 trillion ANNUAL deficit has to be addressed
now if we exempt seniors (those already getting SS) that brings it down to 212 million people to get 1000/monthly (212 billion monthly or 2.544 trillion annually.... still a 1.644 trillion annual deficit based on Yang's 10% VAT
now if it eliminates all welfare (actual welfare and section 8 and food stamps and wic and a few others) (which it CAN NOT..it wont happen) that is about 600 billion...… so we still have a 1 trillion annual debt additional to the current 1t annual deficit
like I said..I think the UBI plan is certainly better that any of the others that the democrats are offering
so what say you Serger…… do Medicare in steps... or a UBI....
but don't shoot the whole economy on one pipe dream of "free dis and dat and de uder ding"
I listed the total HC expenditures. The point is to decrease this amount not to increase it.
Currently, to cover somebody older who is on Medicare via private insurance would cost a fortune, so there is that. Private insurance reimbursement rates are higher, private insurance overheads are 5-10 times higher, and there is also a profit built in.
Lastly, I'm not married to single payer type of solution. Swiss model is completely private insurance based but it works and HC represents much smaller fraction of their gdp. But, basic premium cost is controlled, also providers, etc.
You're stating that doctor supply needs to be manipulated by the government in certain situations, correct?
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
