Affordable Healthcare

Jan 2014
16,291
6,211
south
It wouldn't be enough to fund UHC. There are still another 150 million in the US that don't get their coverage from their employer and not all employers provide health care benefits.
if I recall correctly, the German system requires all it's citizens to have healthcare - either private or public. last stats I recall is 80% choose the public system and 20% opt for the private system.
 
Mar 2012
56,188
37,767
New Hampshire
It wouldn't be enough to fund UHC. There are still another 150 million in the US that don't get their coverage from their employer and not all employers provide health care benefits.
You also have to factor in all the costs of Medicare, Medicaid, CHIP and the VA since they would all cease to exist under a single payer plan. Everybody would be in the same plan. In Vermont, a teeny tiny state, the cost of single payer would have been over 3 billion a year.

"In 2017, under pre-existing law, the state of Vermont expects to collect $1.7 billion in tax revenue. Green Mountain Care would have required an additional $2.6 billion in tax revenue: a 151 percent increase in state taxes. Fiscally, that’s a train wreck."

https://www.forbes.com/sites/theapo...-plan-was-doomed-from-the-start/#5affc6e34850
 
Jul 2013
54,878
59,078
Nashville, TN
So we go back to 50 million with no healthcare coverage and the rest on watch for medical bankruptcy as soon as they get hit with a 6 figure bill. Sounds like a plan worthy of Brazil.....or Argentina...and in the mean time we can continue to whine, "it costs too much"
 
Mar 2012
56,188
37,767
New Hampshire
I know it isnt popular, but at some point we are going to have to come to terms with the fact that the majority of the adult population within the next 10 years will be on Medicare as the boomers will be that demographic. That is going to leave more automation and fewer younger workers not only paying in to it, but also having fewer paying into their own healthcare which will leave their costs staggering. Its going to break.
 
Sep 2013
44,423
35,458
On a hill
It wouldn't be enough to fund UHC. There are still another 150 million in the US that don't get their coverage from their employer and not all employers provide health care benefits.
The money is there now, but the system is inefficient.

Existing tax revenue would fund much of the system. According to a 2016 study in the American Journal of Public Health, tax-funded expenditures already account for about two-thirds of U.S. health spending. That revenue would be retained and supplemented by modest new taxes based on ability to pay, taxes that would typically be fully offset by the elimination of today’s premiums and out-of-pocket expenses for care. The vast majority of U.S. households – one study says 95 percent – would come out financially ahead.

The system would also reap savings from its powerful bargaining clout, e.g. its ability to negotiate with drug and medical supply companies for lower prices.

snip

Over the past several decades, more than two dozen independent analyses of federal and state single-payer legislation by agencies such as the Congressional Budget Office, the General Accountability Office, the Lewin Group, and Mathematica Policy Research Group have found that the administrative savings and other efficiencies of a single-payer program would provide more than enough resources to provide first-dollar coverage to everyone in the country with no increase in overall U.S. health spending.

Single Payer FAQ | Physicians for a National Health Program
 
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Sep 2013
44,423
35,458
On a hill
So we go back to 50 million with no healthcare coverage and the rest on watch for medical bankruptcy as soon as they get hit with a 6 figure bill. Sounds like a plan worthy of Brazil.....or Argentina...and in the mean time we can continue to whine, "it costs too much"
Sounds like a plan to increase the number of people on the dole; or as Ben Franklin would say, “penny wise and a pound foolish”.
 
Nov 2006
54,523
20,427
Health care spending in the US is over $3 trillion with federal, local and state governments picking up $1 trillion of that already. You would have to raise an additional $2 trillion with new taxes.

Payroll taxes are currently 15% and raise around $1 trillion. You would have to increase that rate by an additional 30% to raise another $2 trillion.

Wouldn't you rather just introduce a federal wealth tax to cover the bill? Wealth in not currently taxed and the super wealthy don't pay much in payroll taxes.
Median income in the US is about 60k. 30% of 60k is $18,000. To think we need a 30% increase in payroll taxes is ridiculous. You don't need a wealth tax if you simply raised what we currently are taxed (1.5%) to about 5% across the board. You would then have a wealth tax if that's what you want to call it. Someone making 50k would be paying $2500 over the course of the year, with someone making 10 million they would be paying $500,000.
 
Nov 2006
54,523
20,427
It is amazing that so few understand how their own health care is paid for.

If your employer has more than 100 employees, it is self insured. It pays a fee to insurance company to administer the plan, but at the end of the day your employ writes a check to cover they cost of your hemorrhoid surgery. Your employer doesn't buy a private health insurance policy in your name. Since the plan is administered by a health insurance company and you have options, it looks like a private plan, but isn't.
bullshit. I work for a company with about 4000 employees and my health insurance card says blue cross on it. Blue cross is a private insurance company.
 
Likes: 1 person
Nov 2006
54,523
20,427
dunno. my quick count (includes Medicare, Medicaid and veterans care) is about 2 trillion dollars.
Not to mention if the plan went into place a significant portion of that 2 trillion would disappear meaning much of that sum would go towards this plan. Anyone saying it will cost 2 trillion MORE is wrong.
 
Jul 2015
2,693
1,608
Maryland USA
Again, I must disclose that I have spent most of my professional life in the hospital industry, so accept or reject my comments with that understanding. Watching the debate regarding the payment, the delivery and cost of our health care, to me, is rather frustrating. It is frustrating because many if not most of the points used in that debate are generally accepted assumptions regarding those topics, not the reality of those topics. For example, most of the hospitals in this country are governmental or "not-for-profit", so there are no stockholder pockets to be filled with excessive profits. Even in the for profit sector, for which I was a part, the same mandates and regulations apply, the only difference is that they must pay taxes. In both sectors, profits are needed to provide the working capital to access new technologies and respond to the changes in delivery, such as the transfer of services from inpatient to ambulatory or outpatient. Funds are needed to comply with the ever increasing government mandates, for example, hospitals had to spend significant sums to accommodate the privacy requirements of the HIPAA as well as the standard billing requirements.

It is agreed that many specialty physicians make significant incomes, but I think the public perceives that the average primary care physician is making far more than actual. The last time I looked the primary care physician was not making multiple hundreds of dollars, their average income approximated $175,000 to $200,000. An income I don't see as excessive due to the responsibilities they assume in our litigious society, the cost of their training and the fact that they were in training when others were advancing their careers.

When some like to suggest that we replicate the systems of other countries, they do so as if they are comparing apples to apples, but they are not. Our population and geographical demographic are significantly different. The total population of many are the same as or less than our uninsured population. In every major USA city there are multiple facilities providing the extensive care for which only a handful are available in other countries. With a governmental single payer system financed exclusively by taxpayers, such duplication of services will become an issue. So the coverage of services not only will need even tighter controls but those allowed to deliver such services as well potentially reducing immediate availability.

It should be remembered that the payment for healthcare is being debated, not the cost of healthcare. There are numerous factors impacting the cost of care specific to our nation. For example, our education system, the better educated a population, the better use of available healthcare resources. Some like to use life expectancy statistics. If accidental deaths and deaths via violence are removed, the USA rises to the top of the list.

I'm quite sure that many do not understand that the payments from commercial payers are subsidizing the payment short falls of the current government programs. Medicare pays what the program perceives to be cost, not actual costs. The Medicaid program does not even pay those costs. Without the commercial subsidization, many hospitals, especially rural hospitals, could not remain financially viable. Without that subsidization, the burden will be placed on taxpayers, all taxpayers.

While I thought the ACA needed some major improvements, I liked the concept of it. Specifically, it sought a form of private sector, government partnership. In my opinion, the best means to finance healthcare in this nation is a workable private/public partnership. It represented a means by which not to place the burden totally on taxpayers. Additionally, I would suggest that the system used in Maryland be examined. In Maryland, hospital rates are controlled by a Commission, much akin to a public service commission. Governmental and commercial payers are subject to those approved rates.
 
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