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It's so simple that the United States is the only nation among all the rest of the first world developed nations that hasn't yet figured it out even though the working examples are easily visible to all.
the problem is that individuals don't want to pay for it.
Go look at Vermont's failed effort.
Add 18-20% new payroll tax and yes..you too can have universal insurance.
You think all those other nations have free health insurance ?
It's so simple that the United States is the only nation among all the rest of the first world developed nations that hasn't yet figured it out even though the working examples are easily visible to all.
When the Dems knowingly sent a bill to the Senate to repeal the provision that disallows the government from negotiating drug prices, McConnell did not allow it. He simply called it socialist and killed it. The Dems are not blameless, they knew it was just to score points and that McConnell would kill it.
Here in the US we tolerate congress representing their donors, not their constituents. The US is not democratic on money issues. It is a plutocracy representing big donors. They let us peons fight over gay marriage because big money people do not care about that. They just care that big pharma NEEDS us to pay 1.5 to 5 times as much as EVERY OTHER country for the EXACT SAME medicines. We tolerate monopoly power in hospital systems. Back billing...
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Originally Posted by rjshae
Current medical financing practices make it impossible for people to withdraw from healthcare plans. We couldn't afford it. It's the distorted economics that needs to be fixed first.
It's so simple that the United States is the only nation among all the rest of the first world developed nations that hasn't yet figured it out even though the working examples are easily visible to all.
Let us examine those bright shining examples.
COVID-19 deaths per Million...
USA: 388 - Private
Britain: 642 - Government-run. NHS is broke and Brits are holding fund-raising events to raise money.
Spain: 606 - Government-run. Spain spent less than the true cost of healthcare
Italy: 575 - Government-funded. Italy spent less than the true cost of healthcare
France: 456 - Government-funded.
Sweden: 523 - Government-run.
Belgium: 840 - Government-funded. Belgium spent less than the true cost of healthcare.
Your odds of survival are much better in the US.
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Originally Posted by grampaTom
Employer based insurance worked because of risk pools.
Wrong.
The Community Rating Scheme is used.
Singles pay higher rates to subsidize Married, Married w/Children and Elderly.
Married pay higher rates (but less than Singles) to subsidize Married w/children and Elderly.
Risk played ZERO role except with respect to a pre-existing condition.
Agreed, before we can fix healthcare insurance, we must first fix healthcare costs:
-significant tort reform including loser pays all legal costs.
-eliminate useless excessive testing to protect Doctors from Lawyers.
No impact. Legal action is not a factor and neither is testing.
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Originally Posted by beach43ofus
-transparent costs and retail prices to eliminate multi-tiered pricing, and to encourage competition.
That is a significant factor.
One reason I refuse to donate blood, is because Hoxworth Blood Center (part of the Red Cross network) will sell my blood to local hospitals for $840/pint (it might be more or less where you live).
When I go to the hospital and need blood, the hospital will sell my blood back to me for $5,600/pint.
However, they may charge you only $3,800 and someone else $6,400.
Note that is largely due to the fact that hospitals can legally operate as monopolies and cartels.
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Originally Posted by beach43ofus
-remove excessive new Hospital regulations to increase competition amongst hospitals.
Now you're just making things up.
No such regulations exist.
When hospitals first started issuing insurance plans in large numbers, it was during the Great Depression.
States were dying for tax revenues from any and every source possible.
The insurance plans issued by hospitals were legally and technically insurance within the plain language meaning of every State's insurance laws.
There was no way in hell a hospital could possibly comply with the asset requirements established by State insurance regulators.
While the asset requirements vary by State, generally speaking, for the total dollar amount of health insurance policies sold by the hospital, 30% would need to be cold hard cash in escrow, 30% in soft assets (readily liquefied) and the remainder in hard assets.
To get around the various State insurance laws, the AHA lobbied the State legislatures to exempt them.
Those laws are known as "enabling laws" and I have posted those statutes from different States on other threads.
They did something else, too.
They allowed hospitals legally operate as monopolies.
The AHA argued that the negative harmful economic consequences of monopoly power would be offset by the free healthcare given to low-income patients.
Seen any of that free healthcare lately?
How much free healthcare do your local hospitals provide annually?
No one knows. Why?
Because when the AHA wrote those statutes, they made damn sure they'd never have to report to anyone ever how much money on "free" healthcare was actually spent.
In other words, the hospitals don't have to give any free healthcare at all and there's no punishment.
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Originally Posted by beach43ofus
-expedite FDA approval for medical devices, and drugs.
That will kill people.
The near-term and long-term effects of drugs are unknown until people start dying because of them.
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Originally Posted by beach43ofus
-have the lowest corp tax rates to attract big pharma & medical device makers, & lower embedded costs.
Unnecessary, because it is not a factor.
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Originally Posted by beach43ofus
-bring medical manufacturing back to America to insure quality & supply chain protection, lower transport costs & time-in-transit, & eliminate import tariffs/costs.
Not possible, because you don't have the labor and it will only increase the cost of healthcare, not lower it.
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Originally Posted by beach43ofus
-make medicare, medicaid, VA patients bid out non-emergency procedures to get 2 quotes if over X$'s.
Not relevant.
Quote:
Originally Posted by beach43ofus
-allow insurance companies to compete across state lines.
They already do.
They have done so for more than 100 years.
Quote:
Originally Posted by beach43ofus
-mandate all procedures over X$'s have a written quote in advance, and no surprise billing afterwards.
Not realistic. Why?
Race is real. For example, your race determines where the artery that feeds your appendix is attached.
If you're White the artery attaches here, but if Black over there, and if Asian on the underside and if Aboriginal over thataway.
But what if someone is mixed race?
You can't really be sure.
So, you start a laparoscopic procedure, then find the artery is not attached where you thought it would be and now you must withdraw and make an incision on the abdomen which takes a lot more time and is more messy and costs more.
Lather, Rinse, Repeat for the liver, gall bladder, spleen, kidneys, pancreas, stomach, small intestine and large intestine. For women, where the arteries attached to the ovaries and uterus differs, too.
When they lose their job, they lose their incomes AND their healthcare insurance...devastating. Unemployment is grossly inadequate.
Americans will have on average 11.7 jobs in their lives. Some of these jobs will be lost unexpectedly, so most Americans will be w/o healthcare coverage at least once. How so?
Some can afford COBRA...some can't. Some can afford subsidized ACA...some can't. Some qualify for medicaid..some don't.
The #1 cause of bankrupcy (62%) in the U.S. is medical expenses, & 78% of those had insurance, but were underinsured...some through employer-provided plans.
Employer provided insurance premiums rise ~5%/yr, or ~40% since 2013, far outpacing inflation.
Conclusion: tying jobs to healthcare insurance does not attain the objectives of; continuous, affordable, & adequate coverage for all.
~1/2 don't get coverage at work.
Many in this group can't afford subsidized ACA coverage, some make too much to qualify for subsidies, but can't afford insurance elsewhere either (gappers). Those who do have ACA coverage are seeing annual premiums skyrocket, and deductibles are too high. This group has unexpected job losses too...
...Pre-ACA, we had 18% uninsured, in 2018 we had 14% (& rising), but with 23M losing healthcare coverage due to C-19 job losses, we are back above the pre-ACA rate of 18%. ACA failed to cover all as promised, and now LESS are covered.
Many places in America are down to just 1 or 2 ACA providers. The ~50% who do NOT get coverage at work, have seen their private market insurance rates (including ACA) more than DOUBLE since 2013 (see CMS link above).
Conclusion: ACA insurance does not attain the objective of; universal, continuous, & affordable coverage.
Summary
Today, we have MORE uninsured Americans than we had pre-ACA, & ~1/2 of those who are insured are paying 100% (2x) more than they were paying 7 years ago, & the other 1/2 are paying 40% more.
The rate of premium increase is much higher in the private insurance sector (including ACA) than in the employer provided sector (100% vs. 40%) which amplifies the failure of ACA.
If the trend lines on all of this indicated improvement, we could ignore it all, but they're not. The trend line shows every metric worsening. The goal of universal, continuous, adequate, & affordable coverage for all is not being met for the overwhelming majority of Americans in either group.
A good argument for national health care, like all of the other advanced nations.
That means everyone must pay the same price for their insurance. That's equal investment.
I can't even by a policy that's equivalent to a group plan as an individual. So fair, so equal. A lot few people have ins through their employer than they have in the past so the HAVE'S are protecting what's theirs and the HAVE NOTS are paying way more for way less.
Do you think it's right and good to handcuff people to a specific job forever because it's probably the only way they can keep their coverage? I don't.
the problem is that individuals don't want to pay for it.
Go look at Vermont's failed effort.
Add 18-20% new payroll tax and yes..you too can have universal insurance. You think all those other nations have free health insurance ?
They don't refer to theirs as "free". Only Americans use that descriptor.
Now let's explore how the average American family of four paying close to $2k per month or $24K per year in addition to their taxes to even get close to the same type of all-inclusive coverage provided in those other countries, somehow thinking they're not paying MORE for less coverage than those other countries where EVERY person has the same and better coverage.
You seem content, and somehow think it's better ,to pay large premiums and still put up with huge deductibles, co-pays, denials and multiple demands for information by cubicle denizens. AND risk personal bankruptcy on top.
The USA will never have universal healthcare because:
1) Employers benefit from having control over a person’s healthcare. A dependent employee is an obedient employee. Our government is owned by Big Business, and Big Business won’t allow universal healthcare.
2) Americans hate taxes, even if it would actually save them money overall. Americans would rather pay $2000/month for a private health insurance plan than pay an extra $1000 a month in taxes for an equivalent universal healthcare plan.
3) Many white Americans believe that too many black and brown people would benefit from universal healthcare at their expense. They see it as a transfer of wealth from white people to undeserving minorities. Racism isn’t going away anytime soon.
Healthcare is one thing that both the plutocrats and the plebeians agree on: it must be obtained by individuals out of pocket or through an employer. Any public alternative is “socialism” and must be crushed.
I can't even by a policy that's equivalent to a group plan as an individual. So fair, so equal. A lot few people have ins through their employer than they have in the past so the HAVE'S are protecting what's theirs and the HAVE NOTS are paying way more for way less.
That's odd. As a self-employed business owner (mostly retired, now), I belong to a professional organization that offers a group plan, as many do, and have always been able to buy a policy at a group rate.
Quote:
Do you think it's right and good to handcuff people to a specific job forever because it's probably the only way they can keep their coverage? I don't.
You can thank FDR for that... just one of the many mistakes he made, condemning many to suffer his legacy.
FDR froze workers' wages in 1942 by Executive Order. To compete for competent workers, employers began offering benefits like health care/insurance, etc. Thus, our current employer-provided health insurance system was born.
Another key way in which FDR messed up... Economists now recognize that FDR's ill-advised policies prolonged the Great Depression by at least 7 years, keeping millions in unnecessary misery.
USA: 388 - Private
Britain: 642 - Government-run. NHS is broke and Brits are holding fund-raising events to raise money.
Spain: 606 - Government-run. Spain spent less than the true cost of healthcare
Italy: 575 - Government-funded. Italy spent less than the true cost of healthcare
France: 456 - Government-funded.
Sweden: 523 - Government-run.
Belgium: 840 - Government-funded. Belgium spent less than the true cost of healthcare.
Your odds of survival are much better in the US.
Wrong.
The Community Rating Scheme is used.
Singles pay higher rates to subsidize Married, Married w/Children and Elderly.
Married pay higher rates (but less than Singles) to subsidize Married w/children and Elderly.
Risk played ZERO role except with respect to a pre-existing condition.
Cherry picking countries...again. Where is Canada, Australia, New Zealand, Uruguay, etc??
Plus, it ain't over. As the headlines for Canada are this
I have also posted a few times that I don't believe that having UHC in a pandemic guarantees a great outcome, too many variable involved. However, in the area of easily streamlining services, it does help. What really matters is a plan. Canada had a plan, especially after SARS. Yes mistakes and weaknesses were shown, but overall we are doing fine.
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