Bernie

[No. 1 son]

link

[minx]

I think it's very ambitious, but I wonder where the money is going to come from to pay for it.

Medicare and Medicaid already negotiate lower prices for procedures and doctor's visits, so there's not going to be savings there.
Consumers would see a drastic decrease in prices. Businesses would see a huge savings in health care costs, but again, that pays for nothing.
And much as I hate to say it (because I'm not in favor of the present system we have at all), thousands of people will be thrown out of work at insurance companies, hospitals and doctor's offices. What happens to them?

I do think that Medicare/Medicaid for all is not a bad idea, but I do think that those who can afford it pay a premium (ie: Medicare) and those who cannot afford it do not (ie: Medicaid).
I think both options should include both prescription and dental coverage.
I also think that unless you are disabled or totally destitute, you need to have some skin in the game in terms of co-payments. Otherwise, everyone will go to the doctor/ER for a case of the sniffles.

The problem, as always is how to pay for this. I would imagine taxes would have to rise, and if it was paying for health insurance that someone would not be able to afford, I'm for that. OTOH, I'm quite sure that there are many people who would disagree with me (Rally), because they don't see people who are uninsured as their problem.

Another issue is health care 'deserts'. Even if we insured everyone tomorrow, there are many, many people who would lack care simply because there's not a doctor or hospital within a reasonable distance. Perhaps we should look into solving that problem first before extending insurance coverage. I really don't know.

[bobathon]

Fair tax, duh.
Also, all those moneys not being spent on private insurance.

We never worry about how to pay for war, but we must not impose on the overlords when it's funds for doing The Right Thing. So I expect this go-round to come to naught. Soon enough the new economy will take hold, and we will not be expected to adhere to first world standards.

[Dave's Not Here Man]

Here's the question I posed to someone recently during a debate on the issue of single payer:

What if I told you that instead of paying 200 bucks a week for your high deductible family health plan, I could offer you 100% coverage costs with no deductibles, no copays, and no charge for medicines and medical equipment/supplies for around half that cost?

The answer, of course, was, SIGN ME UP! Until I said that instead of an insurance premium paid to BCBS or Humana or whoever, that would be part of your taxes......... and of course, then it's NO FUCKING WAY!!!!!

[No. 1 son]

Sept 13, 2017 19:20:49 GMT -5 Dave's Not Here Man said:

Here's the question I posed to someone recently during a debate on the issue of single payer:

What if I told you that instead of paying 200 bucks a week for your high deductible family health plan, I could offer you 100% coverage costs with no deductibles, no copays, and no charge for medicines and medical equipment/supplies for around half that cost?

The answer, of course, was, SIGN ME UP! Until I said that instead of an insurance premium paid to BCBS or Humana or whoever, that would be part of your taxes......... and of course, then it's NO FUCKING WAY!!!!!

Cutting the cost in half sounds good, but not everyone has your faith in the IRS to deliver that kind of service. Single payer sounds good, especially if it comes with some oversight to eliminate fraud, and gets a grip on prescription drugs, something I suspect the pharma cartel would not allow. Bernie is on the right track, but he doesn't go into "who is eligible" nor "who will pay for it". Little details like that. Congress would have to write a bill ( or have the AMA and Pharmaceutical lawyers write it for them), and there would be so much pork and back scratching in it you couldn't recognize it from the Defense Bill. link  We will end up with some hybrid system that will please about half the people, if we live long enough. 

[bobathon]

Best we return to a la carte health care, then. Because there is nothing the government can do that isn't corrupt, where private industry is never corrupt. Facts of life.

[Dave's Not Here Man]

I'm not going to pretend I have enough book learnin or God given smarts to know the best way to set it up but I do know that there's at least one or two ways to simplify it. One thing we have to get straight right out of the box is an answer to the question of "who is going to pay for it". Well, the fair tax of course. Not kidding. Of all the things the fair tax could get right, there you go. But since it's otherwise a douchey idea, then the answer is "all of us". We all pay for it. We pay for it out of our income taxes and other taxes. I know that's a terrifying if not outrageous suggestion, but remember, you no longer have to rely on your employer to pay out of their pockets for your health care, and you don't have premiums or other costs coming out of yours. Remember, your employer is spending less on your benefits so you should make more, and now that your cost for health care is half-ish as well, then with my 10th grade math B-, seems to me like that's an economic incentive in and of itself where everyone wins.

If it were me, I would contract with Kaiser Foundation to craft a single payer plan, perhaps in cooperation with officials from other parts of the world with working socialized medicine models. Again, I only graduated HS by the skin of me seat, but if I need a building built, I call an architect first for concept, then the engineers to make sure it's built to spec.

[bobathon]

That's how insurance always works - everyone pays for it.

[pasta]

thousands of people will be thrown out of work at insurance companies, hospitals and doctor's offices. What happens to them?

Hopefully most of them get jobs in the shiny new NHS.

[bobathon]

The downside to that financing approach, jeez, is that employees are held less hostage to their employer.

[Dave's Not Here Man]

Yeah, sucks for the hostage takers.

I expect this to get off the ground about as high as I can jump.

[bobathon]

Probably so, but the pressure is in the right direction, and it's revealing that's what we all want anyway.

[rally2xs]

The Fair Tax might have to be in excess of 100% to pay for a single payer system.

In England you can wait up to a year to get a knee replacement in order to go back to work. Here, its about a month. That's socialized medicine - rationing by waiting lists. We worry about our currently expensive healthcare system bankrupting those needing care, but a guy with a bum knee that has to wait for a year to get it fixed to go back to work is going to lose his house anyway... and probably be tossed out on the street to live in a homeless tent city.

We already have a single payer system, the one for the service people, the VA system. Ask the 1000's who have died on waiting lists how well it works.

The inherent drawabacks of such a system, combined with the uniquely high pay of American doctors (probably about 4X the pay of doctors in other parts of the world) PLUS all the malpractice suits that skyrocket the doctor's malpractice insurance would make this so expensive we'd all die of inefected hangnails before we ever got with in 6 blocks of a doctor's office with a valid appointment.

[rally2xs]

"If it were me, I would contract with Kaiser Foundation to craft a single payer plan, perhaps in cooperation with officials from other parts of the world with working socialized medicine models."

There aren't any that work as well as ours WHEN YOU CAN PAY FOR IT. If you got $$$, your best bet to get cured of whateveritis is to show up at an AMERICAN hospital. Your chances of a cure there are the highest on the planet. The biggest reason for that is that you get treated sooner rather than later. With other, "free" healthcare around the world, you WAIT to get seen by a doctor, and your cancer continues to grow, your infection continues to rage, and your chances of getting better continue to plummet.

If we get one of the cockeyed gov't healthcare schemes, many more 1000's will die earlier than they would have. These would be the people that worked hard, saved up their money, and have enough of it to buy their own healthcare insurance.

The answer to this is NOT to design a country that is friendly for poor people and coddles them from cradle to grave. The answer is to restore prosperity to America, so that MOST people can afford their own health insurance, and diminish as much as possible those that cannot care for themselves. That, BTW, is exactly what Trump is trying to do at every turn. He is trying to bring jobs back, so people can work and prosper and buy their own insurance. He's trying to take the hopelessly poor illegal immigrants the hell out of American society and send them back to their own countries where WE don't have to pay for every expense they have, because they can't pay for any of it.

[minx]

Sept 18, 2017 10:37:07 GMT -5 rally2xs said:

WHEN YOU CAN PAY FOR IT.

And that precisely is the point here - many, many people cannot afford to 'pay for it' or do not have good healthcare choices through their employer.
As a personal example, my employer offers United HealthCare. NONE of the current doctors I see participate in it. So what? I say to myself "I'll pay out of pocket and get reimbursed" Well, guess what? If your doctor doesn't participate, then none of the prescriptions they write are covered, even if you go to a participating pharmacist. So not only I paying a premium, carrying the full retail price of my doctor's visits up front, but now I don't get reimbursed for shit.

Luckily I have a spouse that works for the Federal Government, so I can just use his benefits. Unfortunately not all of my co-workers are in that boat, so they're stuck with this crap-o-la coverage. And I'm sure they are not alone - at least my company opted for a company that gives you some choice of doctors. I've worked for places where your only choice was a HMO.

I know you'll never agree Rally, but you're damn lucky that you worked for an employer where you got a choice between many affordable health plans. Outside of the Federal Government, I have NEVER seen that in any company. Just because you were lucky enough to get that, you need to realize that millions of Americans have no choice at all in what they get or how 'affordable' it is.

[bobathon]

He's a moron, minx. We all paid for his goddamned prostate work, that's how insurance works, but he is king of e pluribus I got mine bitchez. Ungrateful jackass.

[rally2xs]

Sept 18, 2017 12:32:03 GMT -5 minx said:

Sept 18, 2017 10:37:07 GMT -5 rally2xs said:

WHEN YOU CAN PAY FOR IT.

And that precisely is the point here - many, many people cannot afford to 'pay for it' or do not have good healthcare choices through their employer.
As a personal example, my employer offers United HealthCare. NONE of the current doctors I see participate in it. So what? I say to myself "I'll pay out of pocket and get reimbursed" Well, guess what? If your doctor doesn't participate, then none of the prescriptions they write are covered, even if you go to a participating pharmacist. So not only I paying a premium, carrying the full retail price of my doctor's visits up front, but now I don't get reimbursed for shit.

Luckily I have a spouse that works for the Federal Government, so I can just use his benefits. Unfortunately not all of my co-workers are in that boat, so they're stuck with this crap-o-la coverage. And I'm sure they are not alone - at least my company opted for a company that gives you some choice of doctors. I've worked for places where your only choice was a HMO.

I know you'll never agree Rally, but you're damn lucky that you worked for an employer where you got a choice between many affordable health plans. Outside of the Federal Government, I have NEVER seen that in any company. Just because you were lucky enough to get that, you need to realize that millions of Americans have no choice at all in what they get or how 'affordable' it is.

And I say again, the cure for this is not to diminsh everyone else's healthcare in order to maintain large pools of poor people that can't pay their own way.  The way to cure this is to dramatically diminish the number of people that cannot pay their own way by making them solidly middle class.  This is done by returning GOOD manufacturing jobs back to the country from overseas, and nuking business taxes would do that.

"Outside of the Federal Government, I have NEVER seen that in any company."

It used to exist in the form of employer sponsored healthcare from many many employers until the income taxes made doing business in the USA an austere, barely viable thing.   Getting rid of the income taxes entirely would supercharge our businesses, and we'd have millions of GOOD jobs available that would come with outstanding healthcare sponsored by employers once again.   Why?  Because if an employer _didn't_ sponsor a good healthcare package, the workers would all beat feet down to the factory down the block, and work for the employer that does.

Stop enabling huge masses of poor people.   Create prosperity instead.  Make them solidly middle class.  Abolish the income taxes.

[rally2xs]

Sept 18, 2017 14:53:07 GMT -5 bobathon said:

He's a moron, minx. We all paid for his goddamned prostate work, that's how insurance works, but he is king of e pluribus I got mine bitchez. Ungrateful jackass.

_I_ paid for the damned prostate work.  You didn't write 1 line of code at my job that was credited to my work, I wrote it all.   _I_ paid for it through my work.   Go fuck off, you lying piece of shit.

[rally2xs]

Sept 13, 2017 12:44:46 GMT -5 minx said:

I think it's very ambitious, but I wonder where the money is going to come from to pay for it.

Oh, hey, lets explore that!

What's it cost to insure 1 guy? (me!) I have my gov't insurance that I pay about $315 s month for, which is 1/3rd of the total premium, so that's roughly $1K / mo or $12K / year.

What's the average salary? $42,000 I think I read the other day. I think Medicare / Medicaid is about 1.65% if I remember right, so that's another 0.0165 X 42,000 = 693 / yr. So, that's $12.7K / yr.

Now, multiply that fully-funded healthcare (I don't pay for anything but drugs) by the number of people in the country, 320 million.

320,000,000 X $12,700 = $4.064 X 10^12, my scientific calculator says, meaining 4.065 trillion dollars. We only take in about 4 trillion dollars from all sources, - income taxes, tariffs, excise taxes, etc. - right now, and since the medicare part of it is so infinitesimally small compared to my full-up insurance, that pretty much means doubline EVERYONE's taxes. Everyone. Now, you're not going to drag that much $$$ out of "the rich", they flat do not have that much money. They don't. The real $$$ is in the middle class, 'cuz there's so many of us.

But of course the real tax bite would be much, much more, because gov't waste, fraud, and abuse is FAR higher than the private industry equivalents that exist in my Blue Cross Blue Shield policy, the one that the gov't pays 2/3rds of.

So, you want your personal income taxes, your payroll taxes, all the excise taxes to double or maybe triple to pay for this monstrosity? I don't.

OBTW, the doctors are less motivated when they're working for the gov't - they get $X per year regardless of working 8 hrs a day or 12 - 14 hrs a day like a lot of them do now. Remember reading about the infamous Phoenix VA hospital with a huge backlog of heart patients waiting forever to see one, while they were working 8 hrs a day, while their local counterparts were into the 12 - 14 hrs a day relm. Why? 'Cuz the locals weren't on salary, they made more $$$ for the extra effort. That's working for the gov't.

"Universal Healthcare", especially in the USA, would kill millions, and that's a fact!

[minx]

And I say to you, having worked in the private sector for almost 30 years that I have NEVER, EVER, EVER been given a choice as to what health care plan my employer chose to offer me. Every employer had 1 or at the most 2 plans to choose from - this has been the case from when I was 20 until now. All of my health insurance has ALWAYS been subsidized by my employer, and with the exception of when I worked for BC/BS itself, it has all uniformly SUCKED.

You are totally delusional if you think in any way, shape or form that employers will "beef up" their health insurance options or pass any cost savings on to their employees.
In addition, the insurance that you enjoy comes courtesy of the Federal Employees Union - don't delude yourself for a minute that Congress wouldn't cut the FEHB program if they thought they could get away with it.

[bobathon]

Told ya so.

[Dave's Not Here Man]

You are totally delusional

You could've started and finished with that,
and saved the wear on your keyboard.

[rally2xs]

Sept 18, 2017 17:22:44 GMT -5 minx said:

And I say to you, having worked in the private sector for almost 30 years that I have NEVER, EVER, EVER been given a choice as to what health care plan my employer chose to offer me. Every employer had 1 or at the most 2 plans to choose from - this has been the case from when I was 20 until now. All of my health insurance has ALWAYS been subsidized by my employer, and with the exception of when I worked for BC/BS itself, it has all uniformly SUCKED.

You are totally delusional if you think in any way, shape or form that employers will "beef up" their health insurance options or pass any cost savings on to their employees.
In addition, the insurance that you enjoy comes courtesy of the Federal Employees Union - don't delude yourself for a minute that Congress wouldn't cut the FEHB program if they thought they could get away with it.

You are simply wrong.  When full employment is achieved with mostly good jobs (hasn't happened since the 60's, which is why you haven't seen it in your limited 30 year experience), the employers will enter a state of supply and demand for labor, and will compete to attract help.   You don't necessarily select multiple choices of health insurance from the same employer, instead you select much better health insurance by going to work for the employer that offers it.   Of course it'd have to be a LOT better to make such a decision, but then if your employer is offering much _worse_ healthcare you will have a lot of company in walking down the block and going to work for someone more reasonable about compensation.  

This hasn't been the case since the 60's, because the other big round of "full employment" was under Reagan and to a lesser extent Clinton, but by that time the income taxes had a good hold on chasing the good jobs out of the country.   Japan was offering Detroit "foreign aid" - no shit, they did that - during Reagan's reign while everybody erroneously blamed low Japanese wages for sucking the jobs out of the USA.   No, it was the damned income taxes.   Its still the income taxes.  And of we don't get rid of 'em, it will always be the income taxes.   

And again, supply and demand says wages spiral up in order to attract employees in a full-employment situation.   Full-employment means you have to drag people off the couch and away from their soap operas in order to find the help you need.  You need a damned big salary to do it.  If you don't, then you continue at your lower output, and make your widgets at $1.00 profit for a max output off 100,000 per day, when you could add another shift instead and make a profit of $1.00 each for 150,000 per day, assuming you had 2 shifts running already.   That's how it works.   You might have to up your wages by 20% to do it, but and cut into your profit so you're only making 80 cents a widget, but 3 shifts yielding 150,000 widgets gets you $120,000 a day profit which is better than 2 shifts of 100,000 widgets at $1.00 profit for only $100,000.   But that's full employment working for everyone, getting the couch potato a good job, and getting the manufacturer more profit.

[pasta]

I love it. In one post, he gets all indignant about how "HE" paid for his health care, and in the. very. next. post. he confirms he only pays 1/3 of his own premium. Not 1/3 of his health care, but only 1/3 of his premium.

Hilarious.

[rally2xs]

Sept 21, 2017 20:35:16 GMT -5 pasta said:

I love it. In one post, he gets all indignant about how "HE" paid for his health care, and in the. very. next. post. he confirms he only pays 1/3 of his own premium. Not 1/3 of his health care, but only 1/3 of his premium.

Hilarious.

I paid the required amount.   The gov't paid the 2/3rds 'cuz I earned it, it was part of my compensation.   It was _all_ my effort that funneled the money to the insurance company.   Works just like any other employment compensation package.  I understand some are even better where 100% of the health insurance is paid "from the employer" and doesn't diminish the employee's take-home pay.   Didn't have one of those, but those that do are _STILL_ paying it themselves via their efforts at their jobs.

[bobathon]

You continue to demonstrate that you have no understanding of how insurance works. Everyone pays for everyone's care. Duh.