Affordable Healthcare

Nov 2006
54,624
20,473
#11
I think we can start with single payer and allow for a buy in. Medicaid stays intact, like it has always been.
Yes it does, those would be the people who get an insurance card that has a zero deductible.

Most of us contribute to our employers for our insurance and it is deducted from our paychecks. We could easily pay those premiums to Medicare instead of Blue Cross for example. As an incentive, our employers should share the cost with employees and it would save them money. Keep the copays or coninsurance percentages with a reasonable deductible.
You keep making the issue more complex with coinsurance and copays and medicaid and medicare. Medicaid is duplicated with a low or zero deductible, medicare is duplicated by that formula that determines the deductible for those retired. The hospital only has to look at your card and all those factors have been addressed.

I saw an article where we would pay about 600 a month to buy into Medicare and that is reasonable to me...at least the insurance would be better than the crappy policies the ACA exchanges offered. I am already paying 600.00 a month through employer insurance and it is a crappy policy so I would rather invest those dollars into a insurance program that is much better, such as Medicare.
There would be no such thing as a "better" insurance policy when it comes to what your plan covers, it covers the same thing as everyone's whether they are 2 or 92. And Medicare is reasonable? What, they have a half dozen different options as it is now? I would advocate that however the employer is currently treated he should not be asked to contribute more. Medicare and medicaid would simply be historical terms for how we used to do things.
 
Likes: 2 people
Nov 2006
54,624
20,473
#12
We spend almost $3 trillion now on health care in the us so why would $1.5 to $3 trillion be a problem?
I don't give a shit what we currently pay that is meaningless. It is estimated that UHC would be an additional 1-3 trillion so that is the only figure applicable in the discussion.
 
Sep 2013
45,071
36,151
On a hill
#13
Yes I am sure. I am also sure that all those layers you speak of is probably why healthcare costs so much. I think simplification is the most important step to making it affordable.
As an example:

A friend recently had a hip replacement, and needed to use a walker during recovery.

Medicare only covers the walker if you get it through a supplier that is enrolled in the Medicare program; if you aren’t sure, always double-check with the supplier first. In addition, your costs will be lowest if you use a “participating” Medicare provider, meaning the supplier has agreed to accept the Medicare-approved amount as full payment (although you’ll still be responsible for cost sharing). If you do not use a DME supplier who participates in Medicare and accepts assignment, there is no limit to the amount you can be charged for your walker.

https://medicare.com/coverage/does-medicare-cover-walkers/
Buying from a medical supply store that accepts medicare, the cost of a walker is $140. The same walker purchased at a drug store is $40.
 
Likes: 1 person
Nov 2006
54,624
20,473
#14
As long as participation in both access and funding is voluntary, I'm all for a government solution. It just has to be designed well enough that people want to opt in. If a quality product is offered at an affordable price, people will purchase it.
You don't purchase anything. If you would prefer to not participate and throw your card in the garbage and pay your medical with your cash you could always do that.
 
Apr 2018
11,840
3,058
oregon
#15
You don't purchase anything. If you would prefer to not participate and throw your card in the garbage and pay your medical with your cash you could always do that.
As long as people get a tax deduction for not using it, I'd be okay with that as well. They could then apply those savings to their own care if/when they need it.
 

Jets

Former Staff
Feb 2011
22,871
13,166
New York
#16
It seems we are trying to agree on a maximum spending level for health care and using means testing to determine the deductible as our starting point.
 
Sep 2013
45,071
36,151
On a hill
#17
I don't give a shit what we currently pay that is meaningless. It is estimated that UHC would be an additional 1-3 trillion so that is the only figure applicable in the discussion.
Who makes that estimate?

What do they base their estimate on?

This organization says we could end up spending less:

A national health insurance program could save approximately $150 billion on paperwork alone. Because of the administrative complexities in our current system, over 25% of every health care dollar goes to marketing, billing, utilization review, and other forms of waste. A single-payer system could reduce administrative costs greatly.

Search PNHP | Physicians for a National Health Program
and

A single-payer model would eliminate the inefficiencies of fragmentation by converting public programs such as Medicare, Medicaid, and CHIP into a single administratively efficient financing system. Streamlined billing under single payer would save physicians vast amounts in overhead [19].

In addition to reduced billing expenses, physicians would also enjoy a meaningful drop in their malpractice premiums. Roughly half of all malpractice awards are for present and future medical costs [20], so if malpractice settlements no longer need to include them, premiums would fall dramatically.

Search PNHP | Physicians for a National Health Program
and

Results: Tax-funded health expenditures totaled $1.877 trillion in 2013 and are projected to increase to $3.642 trillion in 2024. Government’s share of overall health spending was 64.3% of national health expenditures in 2013 and will rise to 67.1% in 2024. Government health expenditures in the United States account for a larger share of gross domestic product (11.2% in 2013) than do total health expenditures in any other nation.

Conclusions: Contrary to public perceptions and official Centers for Medicare and Medicaid Services estimates, government funds most health care in the United States. Appreciation of government’s predominant role in health funding might encourage more appropriate and equitable targeting of health expenditures.

From the Discussion

Americans pay the world’s highest health-related taxes. Yet many perceive that US health care financing system is predominantly private, in contrast to the universal tax-funded health care systems in nations such as Canada, France, or the United Kingdom. By 2024, government expenditures in the United States are expected to account for more than two thirds of national health spending.

U.S. health system is already predominantly taxpayer funded | Physicians for a National Health Program
Much, much more at the links.
 
Sep 2013
45,071
36,151
On a hill
#18
It seems we are trying to agree on a maximum spending level for health care and using means testing to determine the deductible as our starting point.
The trouble with means testing (other than the political issue, and opportunities for abuse) is that we have to pay the means testers.
 

Jets

Former Staff
Feb 2011
22,871
13,166
New York
#20
The trouble with means testing (other than the political issue, and opportunities for abuse) is that we have to pay the means testers.
That’s true, but how else would that deductible be determined based on Pragmatists parameters?
 
Likes: 1 person