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.
Um... Did you look at the chart? The EU-28 countries tax at a much higher than a 29% effective tax rate on the average income earner.
Lol, I know it is hopeless but let me try. It was an example explaining to you why the rates are so high in that table. They are calculated differently.
In my example, depending which definition of tax rate you use, that person would have zero or 29% tax rate, a huge difference, got it? So as a minimum if you try to compare tax rates to make a point, you need to calculate them the same way
No. Across America, on average, we consume about $12,000 PER PERSON in health care goods & services. This is not the limited subset of Medicare patients; it averages in the below-average-compensated Medicare goods and services and above-average compensated non-Medicare goods and services. It all adds up to and averages about $12,000 per person for EVERY man, woman and child.
THEREFORE, a Medicare-for-all system of insurance MUST cost, on average, about $12,000 PER PERSON for every man, woman, and child to pay for the underlying health care goods & services plus more for administration (which is not free).
The arithmetic is both ineluctable and incontrovertible: the average is the average is the average is the average. Divide TOTAL health care goods and services consumed in aggregate in the USA by the total number of human beings in the USA -- including the healthy 40 year old who hasn't seen doctor in 30 years, the 70-something who goes to a doctor 3x week plus 2.5x per week for kidney dialysis, the 5 year old who hasn't been to a doctor since birth but has received vaccinations from public health agencies, etc, the expectant mom, the preemie infant with fetal alcohol syndrome in the NICU, the healthy high school football player who has to have a physical exam each year, the skier who broke his leg skiing, etc.
The result of that arithmetic operation is about $12,000 per person.
Although we talk about "health insurance," note that is a misnomer. What we really mean is "prepaid healthcare" in that what we want is to pay a fixed amount each month for necessary health care goods and services (typically excluding most cosmetic procedures including optional boob jobs, tummy tucks, butt lifts and nose jobs not deemed necessary for medical reasons). Thus, to pay for that $12,000 per person means the insurance premiums MUST BE on average $12,000 per person per year, plus more to cover administration.
No one disagrees. But in a Medicare for All scenario, that family of 4 must pay $12,000 per person to cover their fair share of the national total.
Everyone pays $12,000 per person -- the young family of 4, the elderly couple, the CEO of a Fortune 500 company, the blue-collar worker, the high-tech worker -- everyone is covered under Medicare for All and everyone has a $12,000 per person burden to pay for Medicare for All.
Currently, Medicare rates are below average. Many people mistakenly think Medicare for All means everyone gets to pay below average, and clearly not everyone can pay below average.
Everyone must pay the average. If you allow some selected group to pay LESS than the average, then to maintain the average, some other selected group must pay MORE than the average, because it all adds up and averages out to, you know, the average. $12,000 per person per year for EVERY man, woman, and child in the USA. Plus more for administration.
The notion that that young family of 4 with a lower risk profile can get away with paying less implies others with a higher risk profile -- typically the elderly -- must pay more. Are you going to tell Grandma & Grandpa that they must pay, say, $18,000 per person per year for a sum of $36,000 so that the young family of 4 across the street can pay a mere $24,000 instead of their required $48,000?
*****
At the end of the day, Medicare for All does nothing to reduce the cumulative total of all medical goods and services consumed in the USA. Nothing.
I get what you are saying.
But we cannot yet know what a M4A will cost me, you or anyone.
We can't know all the funding. Taxes, premiums, copays, deductibles, max OOP, and how much deficit spending or any other new central money creation plan might be utilized in funding.
We can't know how M4A would impact seniors or families of 4.
Sure we can guess and project. But averages can misleading when our seniors consume vast amount of HC resources, while most of the younger and healthy middle America uses per capita much less.
Of course any plan will not fly if seniors or families of 4 have to pay much more.
I would bet that a M4A plan would include more and broader central price controls like Medicare does today. So although I would expect the total numbers of medical encounters to increase, the cost per encounter would more likely be lower on average.
At the end of the day our overall HC costs are not going down.
The way I see it , the only way to sell this to the masses is to actually show each individual how it will benefit them. I see article after article on how much we as a whole spend and how much as a whole we will save by going to "free" healthcare insurance for all. That doesn't cut it. I want to see it in plain math. Here is my income, here is what I pay now...show me the savings.
Your income is irrelevant.
On average, each of us consume about $12,000 per person per year in health care goods and services.
Under Medicare for All, each of us will consume $12,000 per person per year in health care goods and services.
You're fair share -- and my fair share -- is about $12,000 to cover those health care goods and services, plus more for administration. If you have kids, their fair share is about $12,000 each, plus administration.
That's an easy calculation. The odds are 100% that doctors start refusing the "New Medicare." 100%.
And then what, just fold, and change jobs? Lol. Btw, currently medicare is accepted by most providers. And yes, it reimburses at a lower rate than private insurance.
The gist is if docs are not paid somewhere near their expectations, they will drag their feet. If we don't have happy docs in there, waits get longer, service(s) trimmed. Unwilling docs by the hundreds of thousands IMO doesn't spell success.
U.S. physicians earned on average $313,000 in 2019, according to Medscape’s international physician compensation report. By comparison, the average physician in the U.K. earned $138,000.
The Commonwealth Fund reports that American general practitioners earned a little more than $218,000 on average in 2016, compared with $146,000 in Canada and $134,000 in the U.K.
Drastic pay cuts would inevitably drive physicians to give up the practice. Currently nearly 80 million people in the USA live in areas with too few primary-care professionals, the Kaiser Family Foundation reports. Imagine what that will look like under Medicare for All. Under our current health care system (not under Medicare for All), the country may face a shortage of as many as 120,000 doctors in a decade, according to the Association of American Medical Colleges.
The prospect of lower pay and stressful work would certainly discourage young people from entering the profession. Medical school is expensive; the median graduate takes on $200,000 in debt. It’s time-consuming, too. The typical doctor spends four years in medical school, followed by three to seven years in residency and fellowship. Lucrative jobs in finance, technology and law require far less preparation time.
One report from FTI Consulting found that Medicare for All would reduce the projected number of U.S. physicians in 2050 by about 44,000, including more than 10,000 primary-care doctors. Patients would have to compete for appointments with a dwindling number of overloaded and underpaid doctors.
Everyone would have coverage, but that’s not the same thing as care.
***
About the only feasible way to implement "healthcare for all" (not Medicare for all) would be a national healthcare (not national insurance) system such as the VA Hospital system. Imagine everyone has access to doctors and hospitals via the VA. Physicians might be required to put in, say, 10 years working for such a hypothetical parallel VA system in order to earn their medical license.
You've read the news reports about VA health care. That's what you could look forward to.
$200k isn't enough money? Your average working Joe making $30k to $40k per year or the working poor can't afford the medical bills that result in $500k plus doctor incomes. "Well paid" doctors are well paid because they bankrupt their patients
I believe the average household income in the USA is about $78,000, according to the Bureau of Labor Statistics.
Last edited by RationalExpectations; 02-12-2020 at 11:50 AM..
And then what, just fold, and change jobs? Lol. Btw, currently medicare is accepted by most providers. And yes, it reimburses at a lower rate than private insurance.
The ONLY reason medicare is accepted by many (maybe even most) providers is that they also have non-medicare patients who pay well above the average. Average them out, and you get (surprise) the average.
Doctors cannot accept everyone paying average, as that total revenue would be below the revenue required to keep the lights on.
Under a Medicare for All system, the average must stay the average - about $12,000 per person per year for every man, woman and child in the USA, plus more for administration.
The ONLY reason medicare is accepted by many (maybe even most) providers is that they also have non-medicare patients who pay well above the average. Average them out, and you get (surprise) the average.
Doctors cannot accept everyone paying average, as that total revenue would be below the revenue required to keep the lights on.
Under a Medicare for All system, the average must stay the average - about $12,000 per person per year for every man, woman and child in the USA, plus more for administration.
I will add that my elderly parents live in a retirement/resort destination, so there is a high percentage of seniors in the population. In order for the medical practices to accept a high number of Medicare patients without going bankrupt due to the low Medicare reimbursement rates, they charge Medicare patients thousands of dollars/year in a membership (concierge) fee for the Medicare patients to be able to even access an MD and make office appointments, at all. And Medicare doesn't cover that. It's an out-of-pocket expense.
Quote:
Medicare doesn't cover membership fees for concierge care.
You pay 100% of the membership fee for concierge care.
What it is
Concierge care is when:
A doctor or group of doctors charges you a membership fee.
They charge this fee before they’ll see you or accept you into their practice.
But averages can misleading when our seniors consume vast amount of HC resources, while most of the younger and healthy middle America uses per capita much less.
But we DO know what all the groups averaged together ends up at: $12,000 per person per year of health care goods and services for each and every man, woman, child, infant and elderly human being in the USA.
Quote:
Originally Posted by Hoonose
Of course any plan will not fly if seniors or families of 4 have to pay much more.
Now you're getting into "who pays how much." There are two choices:
a) EVERY man, woman and child owes $12,000 plus administration.
b) SOME people pay less than $12,000 per person per year (say, young families and the elderly), and SOME people pay more than $12,000 per person per year (say, working adults).
Quote:
Originally Posted by Hoonose
I would bet that a M4A plan would include more and broader central price controls like Medicare does today. So although I would expect the total numbers of medical encounters to increase, the cost per encounter would more likely be lower on average.
Nope. The only reason Medicare gets away with price controls is there are non-Medicare patients who pay more. If everyone is Medicare, then everyone must pay the average.
Quote:
Originally Posted by Hoonose
At the end of the day our overall HC costs are not going down.
You and I agree on that one.
The important thing to remember is Medicare for All does NOTHING -- N O T H I N G -- to reduce the total consumption of health care goods and services in the USA.
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.
