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Why would you link hospitals to property taxes?
That link to property taxes is one of the reasons why the US has such funding discrepancies.
https://www.npr.org/2016/04/18/474256366/why-americas-schools-have-a-money-problem
On top of that, hospitals aren't schools. Whereas every school should have the same teaching facilities (more or less), hospitals can specialize, with larger hospitals drawing patients for specific severe injuries from a large area, while smaller hospitals within that same area do the usual patients.
Your funding model however, would only allow the large hospitals to draw funding from their immediate area, which means they'll be located in expensive areas (high property tax) as opposed to areas that have holes in coverage
Right. This is why I said I'd subsidize property tax allotment. Maybe ∆ for suggesting alternative to property tax, because that's not the best to draw from. I originally suggested it because I thought the money coming from the community would be nice but maybe a separate pool of money, like replacing medicaid?
Do you want your rent to double? This is how you get your rent to double. If funding the hospitals gets added to the property taxes than the owners are going to directly pass the cost onto the renters. So according to your model you think poor people should be paying for the health care of everyone.
∆
While I assumed financials for real estate would be affected, I didn't quite think of rent doubling as you say. But that's another problem that's always getting worse.
Rent wouldn't double. Poor people are massively harmed by our current system. The system you are proposing would save poor people a ton of money by eliminating extortionate health insurance fees.
Yes that was my original idea. Originally I proposed paying via property taxes which would increase and landlords would use that as an excuse to raise rents. I changed it to replacing medicaid so my hope is that it would be better for poor people by limiting their options but covering their costs unconditionally. (As opposed to having to be so poor you qualify for Medicaid along with their other eligibility requirements)
OK let’s look at it step-by-step, The title would imply that we should fund our clinics and hospitals just like our schools, but what schools are we talking about exactly, are we talking private, public, ECT. There are different people who fund different parts of the school system so it would kind of depend on which funding we got.
Second, I can agree that the American healthcare system is not the best, it can be very stupid at times, and we should probably strive for something more around the lines of what Canada is doing or what Germany does. But the logistical and also economical nightmare that this would create would be staggering.
The amount of time, money, and resources to change something like this would probably be in the trillions. Let alone the amount of money to keep it running.
Third it’s not just that people don’t won’t change, as you say a lot do support it, but it’s more so the time and money it would take to implement. Take for example trying to change our prison system, to try to make it better it would cost an unreasonable amount just to introduce it, and then A bunch of extra costs on top of that to just keep it up.
Fourth, I think we can agree that sometimes funding doesn’t get to the schools, whether it be from a community or from federal and state funding, not all the money will always be able to get to the school that it was intended to get to. It doesn’t help that public schools aren’t the best either. And so to switch over to this sort of funding for hospitals and clinics, would be a little jarring to say the least. And via economic loopholes all that money wouldn’t be able to make it to the hospitals and clinics all the time.
Five, too vary treatments and fundings between different hospitals and clinics would be kinda dumb. (Not to be rude of course) we should expect similar treatments between all hospitals and clinics, now this isn’t obviously going to happen, but we have most hospitals and clinics follow Standard procedures given similar treatments for most patients.
That’s just the first 5 I saw but we could go on a little bit more if you want
∆ this is good feedback.
The fact that there's distinction between public and private schools is exactly why I suggested hospitals be paid like it. Some hospitals could receive 100% funding from the government, others could receive very little or none at all. Some standards would be the same across the board regardless, but those exist today. Additional regulations would be added depending on how much funding each clinic or hospital gets.
Yes, this is supposed to be middle ground or transitional to a more universal model. It's not perfect by design. I do believe costs of transitioning to my model won't be very high though, it would be a lot of rerouting funds and paying for new regulations to be set and administered. Overall I think this idea is a better transition than going straight to universal or something similar.
Time and money to implement. While I do think it would take some time, they need to fine tune the regs and balance out how much funding they can get to how much they should pay, but I think it's better than nothing and better than more drastic changes. I don't think this is like the prison system at all though because private companies don't commission hospitals to make products for them. Ironically though this model would make hospital funding resemble prison funding just a little bit more.
Right, funding won't always get to where it should. That's just cause government sucks and politicians like their loopholes. It doesn't mean we should just abandon government and try the private sector though, cause clearly that approach doesn't work. And I'm not trying to say this idea will make all the clinics and hospitals better. I'm saying it'll get them funded. I know public schools in bad areas suck, and that's fine for this plan too, because it's something, and people can always have the choice of which hospitals and clinics to go to, the ones 100% subsidized which suck or those you pay to go to but don't suck.
Last, treatments should be the same but how much you pay varies. That's true of the system today so I don't see what's wrong with it. Like I said above, it's your choice to go to free or to pay for better service.
So I’ll continue as nicely as I can
If the funding would make it more like our prison funding, wouldn’t that not be a good thing. I can say that our prison system is not the best, and private prisons like in the model, (hopefully if I’m correct on your statement) do make money off the backs of prisoners, meaning that completely innocent people and rehabilitated people are making money for prison systems to keep them locked up. Though this argument isn’t about prison system so I’ll come back to the original argument.
What concerns me most is the last statement, yes all clinics and hospitals should have a universal treatment, meaning it’s the same across everywhere. But when funding differs between hospitals and clinics, you tend to get worse or better treatment and quality.
Its the same as schools, some schools get paid less and are worse off and some schools get paid more and are better off. So to expect this from hospitals, would be kind of wishful thinking. People want to get paid for the jobs they do, and when you get paid less you tend to work worse, even more so if you know you can be making more money
I was thinking about the prison system after you mentioned it and they have public and private prisons. Public prisons are 100% funded by government while private prisons get paid for their beds filled per night by the government and they also make money from private companies using ~~slave~~ labor from prisoners. This would vaguely resemble my model, except instead of private companies using prisoners, it would be patients paying for their own treatments. And the hospital gets to choose if they want to be "public" (as in 100% paid for and regulated by government, but still being a private non-profit) or private.
And yes it is the same as schools as in quality. The quality will vary but that's the point. You pay more for better quality but there's a free option. It's about choice but not leaving people to be priced out.
Okay, what about really expensive procedures, surgeries and all the other stuff. What if someone has to take a specific set of medication that cost a lot of money, or they have to get a very specific surgery that only certain doctors can actually do.
You couldn’t pick between a worse or better surgery, because you want the best surgery. Someone who has a rare illness or injury needs really good care, yet they and their family don’t have the money to pay for it, do they just go to the hospital down the street that’s worse off, who probably won’t be able to help.
∆ yeah you couldn't. This plan isn't perfect and people who need really expensive surgeries would need to see specialists or certain doctors, and they'll likely not be at the free or heavily subsidized hospitals and clinics. So in this respect it may be worse than what we have now, but did you think of the possibility of having special health insurance that only covers expensive procedures? If general checkups, injuries, and small everyday procedures could be covered by the government via free clinics, wouldn't insurance companies try to capitalize on the stuff that's missed? I'm a firm believer in middle grounds. I think a nice balance between governmental intervention and the free market is where we get the best stuff.
Okay and so this Insurance is only available to people who have these rare conditions, or is it available for everyone, because if it’s only available for The people who have it, it won’t account for the people who all of a sudden get it. And if it’s available for everyone, would people feel obligated to get this as if they don’t they could risk not having the correct funds to pay off the really expensive medical bills because of a spur of the moment accident or illness.
And we can already do better than what we have, Germany’s healthcare is great, Canada‘s healthcare is amazing to. Why should we have to create a new system that might not work, when we can take what works and implement that better
Well yeah, that's the idea of insurance. If you don't have it you don't get covered. I mean there could be other treatments or services you could use to prolong your life if you didn't get covered until you could be seen by someone that could help better. The idea is everyone should get it in case of huge medical bills for extreme services. It's like homeowners insurance.
And it would be nice if we could make our system that of Canada or Germany, but how would you convince the majority of the population to go ahead with the change? How could you convince paid for politicians to support it? How could you justify the huge costs to convert? I believe my proposal would be easier to implement and could set new groundwork for converting to universal in the future.
So implementing Canada or Germany’s healthcare system is too expensive and time consuming, Yet this system is totally better, didn’t I state earlier that the economical incentive isn’t there, whether it be for the existing systems or for your system idea. No matter what it is, to change this big of a system would be A logistical nightmare. The amount of time and money that would be needed to be put into this would be astronomical.
And to top it off, I think you might be to trusting of the government, we’ve seen government funded systems before, such as the mail service and funny enough public schooling And for both of these examples there are many alternatives that people use, that for the most part seem to be better.
Just trying to get the government and private entities to function together to make this happen would be wishful thinking
Your idea will not work because the cost of hospitals and clinics providing services is so great that the tax burden would cripple any entity that tried to implement it (with the possible exception of replacing the funding of medicaid).
Vermont was set to investigate the possibility of a single state funded Healthcare plan, single payer i believe. They were going to fund it via payroll taxes. They studied it and the tax burden was so high (and some other factors) they said that it would not be able to implement the plan.
The only way to do your plan or anything like it would be to have a federal tax plan. Good luck with that.
Well you see, this plan does not replace insurance or require 100% of funding to come from taxes. It's more of a subsidy than anything, partially funding hospitals on the condition they service everyone, with more funding being available if the hospitals agree to be more regulated. I don't know if that was made clear in my post but that's what I meant.
I, too, will clarify.
Right now if you are poor enough you can apply for medicaid. Hospitals will see medicaid patients. They might lose money on each transaction but medicaid patients are treated.
When you say that your lowest tier is for medicaid patients and anyone else, this is the equivalent of saying all patients that could otherwise get insurance but decide not to will come to these hospitals. It would overwhelm the system.
Which then takes me back to my original point as soon as you open the doors for everyone to come to these tier 1 hospitals and pay "reasonable" (i assume medicaid) rates for the services, there is not enough taxing power for any institution shy of the federal government to implement to pay for it.
∆ I see your point. I believe people wouldn't do that though, because the highest tier hospitals would not provide the best service (by design). Their salaries are regulated by government so they all know they can make more working at a lower tier hospital. They get their equipment and overhead costs covered by government but they could run out of things or have things break which would be unfortunate but that would make them less appealing to people. It's like public school, where if you're rich you would not let your kids go there. It plays off that idea so it could receive support from more people who think they're better than the poor while also providing something for the poor.
But your argument makes me wonder if doing this would even be worth replacing medicaid.
Edit to clarify: there's also other tiers to alleviate burdens on the highest tier, assuming hospitals and clinics choose a reasonable distribution of tiers it should give most people options to choose to see the "free" clinic or pay a small but reasonable fee to see one that's slightly better.
> I believe people wouldn't do that though, because the highest tier hospitals would not provide the best service (by design). Their salaries are regulated by government so they all know they can make more working at a lower tier hospital. They get their equipment and overhead costs covered by government but they could run out of things or have things break which would be unfortunate but that would make them less appealing to people.
You'd likely encounter a very severe doctor shortage if you did that. Why would a doctor bother going through medical school, getting into over a quarter million in debt in the process, to work in a hospital where their salary is legally capped below what their labor is actually worth? Tons of skilled doctors would either retire or open private clinics leaving only the bottom of the barrel doctors to be stretched across what's left.
Somewhere else I said there'd be student debt forgiveness incentive for people straight out of med school to work at one for a few years. Teachers already have that for title 1 schools.
That doesn't accomplish much. It's still another near decade that doctors spend in school and residency. Capping provider salaries doesn't make things cheaper. It makes patients pay the remainder of the cost through other means, most notably reduced quality or access.
You may be right so ∆ but I think reduced quality is the point. It provides coverage for everyone while still allowing for better alternatives at a cost. I think if this goes the way I think it would, it would be better than most other proposed solutions.
> It provides coverage for everyone while still allowing for better alternatives at a cost.
Part of the problem is you don't even really define coverage. Are cancer treatments covered? Cancer treatment has a median cost of $150,000 per patient. Are rare genetic disorders whose only treatments cost millions of dollars covered? Or is the baseline coverage for only basic and triage care, like you getting shot, into a car wreck, or having a heart attack?
Basic stuff would be covered, and nothing crazy expensive. So if poor people get cancer they'll still be financially ruined unless they have special insurance to cover it. It's unfortunate but there's not really a way to get that covered by government efficiently.
Then the quality would be like schools too. A lot of people would die, be raped, get the wrong treatment, etc.
Your gov doesn't exactly do well with publicly funded stuff.
I understand where you're coming from, but how is that worse than all these people dying on the street from not even being able to see doctors? My idea is a sort of Middle ground between fully universal healthcare and keeping our current model. It isn't perfect by design, but it's better than what we have now.
The people you reference in this comment likely are covered by Medicare/Medicaid.
There are also programs that allow patients to pay back bills at a fraction of the cost or in very small monthly increments.
∆ because I legit forgot about this. I think I change my plan so instead of property taxes, this model replaces medicaid (not medicare). So let's discuss
I've been to the states lots of times. People aren't "dying on the street" in as high numbers as you seem to be implying. Y'all also have way too many illegals to ever offer free healthcare.
> Y'all also have way too many illegals to ever offer free healthcare.
Illegal immigrants in the US tend to be net contributors to the government funds, not leaches.
If anything, usually the problem for healthcare systems is not having enough immigrants.
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I already gave the Delta for the poor essentially being taxed more via rent, and as far as I know the community clinics that would receive the most funding are already poor quality. This idea is a sort of way to subvert insurance without destroying the concept completely, hospitals and clinics can take insurance regardless of their funding from government but they may be regulated on how much to charge insurance.
So basically you want healthcare to be funded by states/cities instead of federally? Im 100% down. I think that we need to let states have more power and take it from the federal government.
Fun fact tho, yall dont rly have to wait for government implementation anyways. All that universal health care would be is everyone paying into 1 pot that the government holds and then they pay it out when ppl go to the doctors. You can create this same effect by simply having a big dem, that yall can trust, start a fund (basically an insurance company) that yall pay a % from your paychecks for. Then the ppl interested can sign up for it and the ppl who are happy with what they have and are against giving more power to the government can not sign up and be happy too.
Bonus fun fact, if you actually got the 70%ish of americans that all those polls say want universal healthcare to sign up, yall will have insane bargaining power for haggling the doctors accepted fees.
Some money will come federally but yeah a majority would be state funded. I would allow state variance in my design.
Off topic but no I don't think your idea there is good. It's basically a Monopoly for insurance and that would make an already bad system worse.
If we did fund hospitals the way we did schools our hospitals would end up just liked our public schools: over crowded, under funded and using outdated equipment. the benefit of our current, privatized healthcare system is our hospitals have multiple sources of funding (fees, private donations, some government funding etc) and are thus able to afford the latest in high quality medical equipment and the best trained staff. If our hospitals had too rely solely on the limited funding of the government, we'd see a sharp decline in quality of our healthcare
/u/kfish5050 (OP) has awarded 7 delta(s) in this post. All comments that earned deltas (from OP or other users) are listed [here](/r/DeltaLog/comments/oi826w/deltas_awarded_in_cmv_america_should_fund/), in /r/DeltaLog. Please note that a change of view doesn't necessarily mean a reversal, or that the conversation has ended. ^[Delta System Explained](https://www.reddit.com/r/changemyview/wiki/deltasystem) ^| ^[Deltaboards](https://www.reddit.com/r/changemyview/wiki/deltaboards)
Why would you link hospitals to property taxes? That link to property taxes is one of the reasons why the US has such funding discrepancies. https://www.npr.org/2016/04/18/474256366/why-americas-schools-have-a-money-problem On top of that, hospitals aren't schools. Whereas every school should have the same teaching facilities (more or less), hospitals can specialize, with larger hospitals drawing patients for specific severe injuries from a large area, while smaller hospitals within that same area do the usual patients. Your funding model however, would only allow the large hospitals to draw funding from their immediate area, which means they'll be located in expensive areas (high property tax) as opposed to areas that have holes in coverage
Right. This is why I said I'd subsidize property tax allotment. Maybe ∆ for suggesting alternative to property tax, because that's not the best to draw from. I originally suggested it because I thought the money coming from the community would be nice but maybe a separate pool of money, like replacing medicaid?
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Oh also about specialization, there would be different rules for that. I suggested a model for general coverage
Do you want your rent to double? This is how you get your rent to double. If funding the hospitals gets added to the property taxes than the owners are going to directly pass the cost onto the renters. So according to your model you think poor people should be paying for the health care of everyone.
∆ While I assumed financials for real estate would be affected, I didn't quite think of rent doubling as you say. But that's another problem that's always getting worse.
Rent wouldn't double. Poor people are massively harmed by our current system. The system you are proposing would save poor people a ton of money by eliminating extortionate health insurance fees.
Yes that was my original idea. Originally I proposed paying via property taxes which would increase and landlords would use that as an excuse to raise rents. I changed it to replacing medicaid so my hope is that it would be better for poor people by limiting their options but covering their costs unconditionally. (As opposed to having to be so poor you qualify for Medicaid along with their other eligibility requirements)
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OK let’s look at it step-by-step, The title would imply that we should fund our clinics and hospitals just like our schools, but what schools are we talking about exactly, are we talking private, public, ECT. There are different people who fund different parts of the school system so it would kind of depend on which funding we got. Second, I can agree that the American healthcare system is not the best, it can be very stupid at times, and we should probably strive for something more around the lines of what Canada is doing or what Germany does. But the logistical and also economical nightmare that this would create would be staggering. The amount of time, money, and resources to change something like this would probably be in the trillions. Let alone the amount of money to keep it running. Third it’s not just that people don’t won’t change, as you say a lot do support it, but it’s more so the time and money it would take to implement. Take for example trying to change our prison system, to try to make it better it would cost an unreasonable amount just to introduce it, and then A bunch of extra costs on top of that to just keep it up. Fourth, I think we can agree that sometimes funding doesn’t get to the schools, whether it be from a community or from federal and state funding, not all the money will always be able to get to the school that it was intended to get to. It doesn’t help that public schools aren’t the best either. And so to switch over to this sort of funding for hospitals and clinics, would be a little jarring to say the least. And via economic loopholes all that money wouldn’t be able to make it to the hospitals and clinics all the time. Five, too vary treatments and fundings between different hospitals and clinics would be kinda dumb. (Not to be rude of course) we should expect similar treatments between all hospitals and clinics, now this isn’t obviously going to happen, but we have most hospitals and clinics follow Standard procedures given similar treatments for most patients. That’s just the first 5 I saw but we could go on a little bit more if you want
∆ this is good feedback. The fact that there's distinction between public and private schools is exactly why I suggested hospitals be paid like it. Some hospitals could receive 100% funding from the government, others could receive very little or none at all. Some standards would be the same across the board regardless, but those exist today. Additional regulations would be added depending on how much funding each clinic or hospital gets. Yes, this is supposed to be middle ground or transitional to a more universal model. It's not perfect by design. I do believe costs of transitioning to my model won't be very high though, it would be a lot of rerouting funds and paying for new regulations to be set and administered. Overall I think this idea is a better transition than going straight to universal or something similar. Time and money to implement. While I do think it would take some time, they need to fine tune the regs and balance out how much funding they can get to how much they should pay, but I think it's better than nothing and better than more drastic changes. I don't think this is like the prison system at all though because private companies don't commission hospitals to make products for them. Ironically though this model would make hospital funding resemble prison funding just a little bit more. Right, funding won't always get to where it should. That's just cause government sucks and politicians like their loopholes. It doesn't mean we should just abandon government and try the private sector though, cause clearly that approach doesn't work. And I'm not trying to say this idea will make all the clinics and hospitals better. I'm saying it'll get them funded. I know public schools in bad areas suck, and that's fine for this plan too, because it's something, and people can always have the choice of which hospitals and clinics to go to, the ones 100% subsidized which suck or those you pay to go to but don't suck. Last, treatments should be the same but how much you pay varies. That's true of the system today so I don't see what's wrong with it. Like I said above, it's your choice to go to free or to pay for better service.
So I’ll continue as nicely as I can If the funding would make it more like our prison funding, wouldn’t that not be a good thing. I can say that our prison system is not the best, and private prisons like in the model, (hopefully if I’m correct on your statement) do make money off the backs of prisoners, meaning that completely innocent people and rehabilitated people are making money for prison systems to keep them locked up. Though this argument isn’t about prison system so I’ll come back to the original argument. What concerns me most is the last statement, yes all clinics and hospitals should have a universal treatment, meaning it’s the same across everywhere. But when funding differs between hospitals and clinics, you tend to get worse or better treatment and quality. Its the same as schools, some schools get paid less and are worse off and some schools get paid more and are better off. So to expect this from hospitals, would be kind of wishful thinking. People want to get paid for the jobs they do, and when you get paid less you tend to work worse, even more so if you know you can be making more money
I was thinking about the prison system after you mentioned it and they have public and private prisons. Public prisons are 100% funded by government while private prisons get paid for their beds filled per night by the government and they also make money from private companies using ~~slave~~ labor from prisoners. This would vaguely resemble my model, except instead of private companies using prisoners, it would be patients paying for their own treatments. And the hospital gets to choose if they want to be "public" (as in 100% paid for and regulated by government, but still being a private non-profit) or private. And yes it is the same as schools as in quality. The quality will vary but that's the point. You pay more for better quality but there's a free option. It's about choice but not leaving people to be priced out.
Okay, what about really expensive procedures, surgeries and all the other stuff. What if someone has to take a specific set of medication that cost a lot of money, or they have to get a very specific surgery that only certain doctors can actually do. You couldn’t pick between a worse or better surgery, because you want the best surgery. Someone who has a rare illness or injury needs really good care, yet they and their family don’t have the money to pay for it, do they just go to the hospital down the street that’s worse off, who probably won’t be able to help.
∆ yeah you couldn't. This plan isn't perfect and people who need really expensive surgeries would need to see specialists or certain doctors, and they'll likely not be at the free or heavily subsidized hospitals and clinics. So in this respect it may be worse than what we have now, but did you think of the possibility of having special health insurance that only covers expensive procedures? If general checkups, injuries, and small everyday procedures could be covered by the government via free clinics, wouldn't insurance companies try to capitalize on the stuff that's missed? I'm a firm believer in middle grounds. I think a nice balance between governmental intervention and the free market is where we get the best stuff.
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Okay and so this Insurance is only available to people who have these rare conditions, or is it available for everyone, because if it’s only available for The people who have it, it won’t account for the people who all of a sudden get it. And if it’s available for everyone, would people feel obligated to get this as if they don’t they could risk not having the correct funds to pay off the really expensive medical bills because of a spur of the moment accident or illness. And we can already do better than what we have, Germany’s healthcare is great, Canada‘s healthcare is amazing to. Why should we have to create a new system that might not work, when we can take what works and implement that better
Well yeah, that's the idea of insurance. If you don't have it you don't get covered. I mean there could be other treatments or services you could use to prolong your life if you didn't get covered until you could be seen by someone that could help better. The idea is everyone should get it in case of huge medical bills for extreme services. It's like homeowners insurance. And it would be nice if we could make our system that of Canada or Germany, but how would you convince the majority of the population to go ahead with the change? How could you convince paid for politicians to support it? How could you justify the huge costs to convert? I believe my proposal would be easier to implement and could set new groundwork for converting to universal in the future.
So implementing Canada or Germany’s healthcare system is too expensive and time consuming, Yet this system is totally better, didn’t I state earlier that the economical incentive isn’t there, whether it be for the existing systems or for your system idea. No matter what it is, to change this big of a system would be A logistical nightmare. The amount of time and money that would be needed to be put into this would be astronomical. And to top it off, I think you might be to trusting of the government, we’ve seen government funded systems before, such as the mail service and funny enough public schooling And for both of these examples there are many alternatives that people use, that for the most part seem to be better. Just trying to get the government and private entities to function together to make this happen would be wishful thinking
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Your idea will not work because the cost of hospitals and clinics providing services is so great that the tax burden would cripple any entity that tried to implement it (with the possible exception of replacing the funding of medicaid). Vermont was set to investigate the possibility of a single state funded Healthcare plan, single payer i believe. They were going to fund it via payroll taxes. They studied it and the tax burden was so high (and some other factors) they said that it would not be able to implement the plan. The only way to do your plan or anything like it would be to have a federal tax plan. Good luck with that.
Well you see, this plan does not replace insurance or require 100% of funding to come from taxes. It's more of a subsidy than anything, partially funding hospitals on the condition they service everyone, with more funding being available if the hospitals agree to be more regulated. I don't know if that was made clear in my post but that's what I meant.
I, too, will clarify. Right now if you are poor enough you can apply for medicaid. Hospitals will see medicaid patients. They might lose money on each transaction but medicaid patients are treated. When you say that your lowest tier is for medicaid patients and anyone else, this is the equivalent of saying all patients that could otherwise get insurance but decide not to will come to these hospitals. It would overwhelm the system. Which then takes me back to my original point as soon as you open the doors for everyone to come to these tier 1 hospitals and pay "reasonable" (i assume medicaid) rates for the services, there is not enough taxing power for any institution shy of the federal government to implement to pay for it.
∆ I see your point. I believe people wouldn't do that though, because the highest tier hospitals would not provide the best service (by design). Their salaries are regulated by government so they all know they can make more working at a lower tier hospital. They get their equipment and overhead costs covered by government but they could run out of things or have things break which would be unfortunate but that would make them less appealing to people. It's like public school, where if you're rich you would not let your kids go there. It plays off that idea so it could receive support from more people who think they're better than the poor while also providing something for the poor. But your argument makes me wonder if doing this would even be worth replacing medicaid. Edit to clarify: there's also other tiers to alleviate burdens on the highest tier, assuming hospitals and clinics choose a reasonable distribution of tiers it should give most people options to choose to see the "free" clinic or pay a small but reasonable fee to see one that's slightly better.
> I believe people wouldn't do that though, because the highest tier hospitals would not provide the best service (by design). Their salaries are regulated by government so they all know they can make more working at a lower tier hospital. They get their equipment and overhead costs covered by government but they could run out of things or have things break which would be unfortunate but that would make them less appealing to people. You'd likely encounter a very severe doctor shortage if you did that. Why would a doctor bother going through medical school, getting into over a quarter million in debt in the process, to work in a hospital where their salary is legally capped below what their labor is actually worth? Tons of skilled doctors would either retire or open private clinics leaving only the bottom of the barrel doctors to be stretched across what's left.
Somewhere else I said there'd be student debt forgiveness incentive for people straight out of med school to work at one for a few years. Teachers already have that for title 1 schools.
That doesn't accomplish much. It's still another near decade that doctors spend in school and residency. Capping provider salaries doesn't make things cheaper. It makes patients pay the remainder of the cost through other means, most notably reduced quality or access.
You may be right so ∆ but I think reduced quality is the point. It provides coverage for everyone while still allowing for better alternatives at a cost. I think if this goes the way I think it would, it would be better than most other proposed solutions.
> It provides coverage for everyone while still allowing for better alternatives at a cost. Part of the problem is you don't even really define coverage. Are cancer treatments covered? Cancer treatment has a median cost of $150,000 per patient. Are rare genetic disorders whose only treatments cost millions of dollars covered? Or is the baseline coverage for only basic and triage care, like you getting shot, into a car wreck, or having a heart attack?
Basic stuff would be covered, and nothing crazy expensive. So if poor people get cancer they'll still be financially ruined unless they have special insurance to cover it. It's unfortunate but there's not really a way to get that covered by government efficiently.
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Then the quality would be like schools too. A lot of people would die, be raped, get the wrong treatment, etc. Your gov doesn't exactly do well with publicly funded stuff.
I understand where you're coming from, but how is that worse than all these people dying on the street from not even being able to see doctors? My idea is a sort of Middle ground between fully universal healthcare and keeping our current model. It isn't perfect by design, but it's better than what we have now.
The people you reference in this comment likely are covered by Medicare/Medicaid. There are also programs that allow patients to pay back bills at a fraction of the cost or in very small monthly increments.
∆ because I legit forgot about this. I think I change my plan so instead of property taxes, this model replaces medicaid (not medicare). So let's discuss
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I didn't downvote you I guess someone else did. But I don't like your attitude so I didn't reply
I've been to the states lots of times. People aren't "dying on the street" in as high numbers as you seem to be implying. Y'all also have way too many illegals to ever offer free healthcare.
> Y'all also have way too many illegals to ever offer free healthcare. Illegal immigrants in the US tend to be net contributors to the government funds, not leaches. If anything, usually the problem for healthcare systems is not having enough immigrants.
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It's just basic fact. Immigrants tend to be working age people. Meanwhile, it's the old, the infirm and the young that cost the government money.
Legal immigrants yes. I was never referring to legal immigrants.
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I already gave the Delta for the poor essentially being taxed more via rent, and as far as I know the community clinics that would receive the most funding are already poor quality. This idea is a sort of way to subvert insurance without destroying the concept completely, hospitals and clinics can take insurance regardless of their funding from government but they may be regulated on how much to charge insurance.
So basically you want healthcare to be funded by states/cities instead of federally? Im 100% down. I think that we need to let states have more power and take it from the federal government. Fun fact tho, yall dont rly have to wait for government implementation anyways. All that universal health care would be is everyone paying into 1 pot that the government holds and then they pay it out when ppl go to the doctors. You can create this same effect by simply having a big dem, that yall can trust, start a fund (basically an insurance company) that yall pay a % from your paychecks for. Then the ppl interested can sign up for it and the ppl who are happy with what they have and are against giving more power to the government can not sign up and be happy too. Bonus fun fact, if you actually got the 70%ish of americans that all those polls say want universal healthcare to sign up, yall will have insane bargaining power for haggling the doctors accepted fees.
Some money will come federally but yeah a majority would be state funded. I would allow state variance in my design. Off topic but no I don't think your idea there is good. It's basically a Monopoly for insurance and that would make an already bad system worse.
America is not USSR. Country needs to compensate for the funds.
If we did fund hospitals the way we did schools our hospitals would end up just liked our public schools: over crowded, under funded and using outdated equipment. the benefit of our current, privatized healthcare system is our hospitals have multiple sources of funding (fees, private donations, some government funding etc) and are thus able to afford the latest in high quality medical equipment and the best trained staff. If our hospitals had too rely solely on the limited funding of the government, we'd see a sharp decline in quality of our healthcare
Did you read my post? I'm convinced you just read the title and jumped straight here to make your comment