Affordable Healthcare

[Libertine]

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.

Blue Cross is administering your companies self funded health care program for a fee. Your company didn't buy an individual policy for you from Blue Cross. That saves the company a lot of money managing costs and there are tax advantages.

 

[Pragmatist]

Sources seem to vary a lot. It could be $1.5 trillion of $3.5 trillion in health care spending. We would still need to come up with around $2 trillion in new taxes to pay for it.

https://www.taxpolicycenter.org/briefing-book/how-much-does-federal-government-spend-health-care

https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html

Do you think it would be 2 trillion more if the deductible was $100,000. You keep talking as though you know what it will cost when you haven't a fucking clue what the deductible is. if it happens to be $10000 instead of $5000 your number could be cut in half. Your quotes of numbers are all bullshit without knowing.

 

[Pragmatist]

I would suggest a goal of 3 trillion to make it a viable plan. that's what my goal is in my proposal earlier.

A lot of good in that plan but it's overly complicated which inherently makes it more expensive. One card issued yearly depending on your status and everything anyone says about medicare or medicaid is incorporated into it.

 

[bonehead]

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.

understand. thank you. I made a proposal in post# 168. a comment or correction would be appreciated.

 

[Libertine]

Do you think it would be 2 trillion more if the deductible was $100,000. You keep talking as though you know what it will cost when you haven't a fucking clue what the deductible is. if it happens to be $10000 instead of $5000 your number could be cut in half. Your quotes of numbers are all bullshit without knowing.

We are spending about 20% of GDP on health care now. You are suggesting we have a similar system but it be single payer. The cost for a office visit and xray would be similar. The numbers are known.

Vermont and California just went through the same exercise for single payer and guess what, the number was about 20% of state GDP. That's why both states abandoned plans to move to single payer.

 

[Pragmatist]

There is nothing in that article to dispute what I said. Most of the 151 million that receive heath care coverage from employers are in self funded employer plans. The employers didn't buy 151 million individual health care policies. That is the way it works for federal employees, state employees, Google Employees, and most every that works for an employer with 100 or more employees.

Just because an employer has a group plan for his employees does not mean that plan is not using private insurance.

 

[Pragmatist]

You and I know corporations will refuse. They will donate to all the right politicians to get out of that and keep their share. They have done that with unemployment and liability costs. They carry less and less of the burden and we dont care.

I would rather employers pay less of a burden. Too many don't give a shit about healthcare because their employer takes care of everything for them. take that away and there will be a revolution for UHC. Besides, employers don't have to furnish anyone with insurance and many of them don't.

 

[Pragmatist]

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.

countries no where near as rich as ours have UHC so to say we cannot afford it is fucking stupid.

 

[Libertine]

I would rather employers pay less of a burden. Too many don't give a shit about healthcare because their employer takes care of everything for them. take that away and there will be a revolution for UHC. Besides, employers don't have to furnish anyone with insurance and many of them don't.

Actually employers with 50 or more employees are required to provide health care not only for their employees but also for their 25 year old grown children.

 

[Pragmatist]

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/theapothecary/2014/12/21/6-reasons-why-vermonts-single-payer-health-plan-was-doomed-from-the-start/#5affc6e34850

This plan is based on a deductible of what? How can people logically discuss how much it will cost without taking into consideration that factor?