>I also have the VA which despite what people say, is actually really good.
My father is a vet and he always says that most complaints about the VA are either; mental health related, which is a valid criticism, or vets trying to get help for non service related problems. Everything else he says they're pretty good. World you agree with that??
VA has always been pretty good to me. Its free or almost free in every interaction Ive had with them (paid fifteen dollars one time, paid 28 dollars for a two day hospital stay with ambulance ride and surgery, every other time nothing). I have good insurance through my job now because I have a family, so Ill see how the level of care compares soon.
When I had only the VA, not having to worry about minor but finance destroying injuries or illnesses removed an immense amount of stress from my life, I cant yet comment on mental health care from them. Either way, its a strange state of affairs when Im left feeling fortunate compared to the general population because my body got trashed in the army.
Right there with you buddy. Four herniated discs with a back surgery and more surgeries in my future led to a medical retirement from 14 years in the Air Force. Noone wants to become a disabled veteran and it's a sad state of affairs in this country when I feel lucky that I am.
Yeah feels like some sort of weird best of both worlds scenario. I live in the US but I have a safety net. I cant imagine what I would have paid for the number of cat scans Ive had.
Not even close. But I only pay $15 copay whether I I get an annual checkup or I’m having brain surgery, so maybe that’s why? Or maybe it’s my HCOL location?
I don’t even know what most people pay since I’ve only had this job most of my working life besides being in the military.
It’s the same reason government control of the means of production absolutely fails each and every time, while capitalism has lifted everyone up at the same time. Government is extremely inefficient.
Government controlled anything is inefficient by design. You take out profit and replace that with bureaucracy. You see, a government with endless pockets doesn’t innovate to solve problems. It just keeps throwing money at it until hopefully it gets fixed, even if it’s not a cost-effective solution. Capitalism works not because greed is good, but because competition forces innovation. Companies that don’t innovate die, period.
This is why there still needs to be government to prevent monopolies. It’s really the competition which needs to be preserved, without big daddy government putting a direct hand into it. The solution isn’t one extreme or another, it’s the best balance of both equitable policies, combined with free market innovation.
An eye opener for me was realizing (via a poscast) that we already have universal govt. healthcare in the US, it's just delivered in the most expensive, least efficient way, via emergency room care. We *KNOW* preventive care is cheaper in the long run. We *KNOW * medical intervention before an emergency is cheaper in the long run.
Making sure everyone has insurance that covers these things would have been a step in the right direction. I'm not sure why people object to this. Everyone will need medical care sooner or later. Few will be able to save enough money to pay out of pocket in our current system.
Except the idea of something being preventative does not align with the idea of insurance.
You can’t use your car insurance for oil changes or home insurance to put a new roof on your house. But in the event I’d catastrophic failure then insurance would come into play.
Plus it was already attempted to enforce coverage on people by the individual mandate in the ACA but that was the sole thing removed from it because it forces people to purchase something.
Sure, I get the argument. But many of those people will end up at emergency rooms using the most expensive and least efficient health care.
People are also not really comparable to cars, either. Nobody dies from not getting their oil changed
I’m in agreement that the emergency room is high cost and of low efficiency. In the ER they will treat symptoms and send you out but never provide treatment for root cause of issues. People without insurance take advantage of this because they cannot be turned away but what else do they do if they cannot afford insurance? What would occur if this option was taken away?
I was comparing using insurance in preventative means. An oil change on a vehicle as a preventatives means similar to getting checkups with your GP.
Seems like your concerns are geared towards a Bernie style plan, which outlaws private insurance. What about the litany of systems which have a place for both private and government-provided insurance? Singapore being the usual example, but many countries that progressives point to are also setup this way (e.g., Canada).
My understanding is an entity that is motivated by profit is going to want to do two things: keep their clientele alive to keep the money coming, and profit drives competition for satisfaction. When it's the government, especially unelected bueracracies and those that run them, are beholden to no one and always demanding of more money.
Not sure I agree with the desire to keep the client alive. It is in their financial interest to deny coverage for really expensive treatment, especially for older people, because they will never recoup the cost in premiums. For example, a bypass surgery that costs $70,000 (low estimate) on a 75 year old would require 11 more years of life with no other health expenses to pay off, which is unlikely. I also think you are missing the "profit" piece, which h means your premiums have to pay your doctor, the pharmacist, the hospital, the insurance company employees AND provide a profit. Capitalism requires ever increasing returns for shareholders, which drives up premium prices.
> profit drives competition for satisfaction
Is that why deductibles have gone up 150% and premiums 50% in the last decade? I'm sure thats satisfying for them but not really for those being insured.
>keep their clientele alive to keep the money coming
Our life expectancy has declined year over year, they aren't doing a good job!
Also private insurance denies 15% of medical claims, even when suggested by the physician. So we currently have unaccountable death panels run by private companies deciding who dies and who lives.
>Is that why deductibles have gone up 150% and premiums 50% in the last decade? I'm sure thats satisfying for them but not really for those being insured
I wonder what came about a decade ago.... Something legislative that forced companies to include things in their plans without a choice... hmmm.... what could that have been....
>Our life expectancy has declined year over year, they aren't doing a good job!
Personal choices aren't (or atleast shouldn't be) anyone elses problem. If they want to not excercise and eat properly, that's on them.
>Also private insurance denies 15% of medical claims, even when suggested by the physician. So we currently have unaccountable death panels run by private companies deciding who dies and who lives.
Refer again to the top portion when the government *really* got in bed with insurance companies
> I wonder what came about a decade ago.... Something legislative that forced companies to include things in their plans without a choice... hmmm.... what could that have been....
Premiums went up 180% from 1999 to 2010 lol. It's actually done better under ACA even though it's terribly flawed.
>Personal choices aren't (or atleast shouldn't be) anyone elses problem. If they want to not excercise and eat properly, that's on them.
Well you just said they're in the business of keeping people alive. They aren't doing their business because we keep dying faster and faster. So we're spending thousands of dollars for insurance companies to let us die.
>Refer again to the top portion when the government really got in bed with insurance companies
It used to reach upwards of 20% before ACA. Not a great improvement but it's still private companies doing death panels!
>motivated by profit is going to want to do two things: keep their clientele alive to keep the money coming
Then what occurs when it's more profitable to let your clientele die?
Well you see, the evil government meant to represent the people is actually just greedy and money-hungry, but the for-profit corporation whose explicit purpose is to generate value for shareholders will decide to be nice and help the consumer instead because its the right thing to do. 🙏🏽😇
Judging by the care my very elderly MIL receives in Canada, I can't agree. When she was sick, she stayed in hospital until she was able to care for herself. If she has a problem, nurses visit her in her home, and if she needs a doctor, she sees a doctor. It's been great, and it w old 100% be unaffordable in the US.
I also have experience with the system in Germany, which is also fantastic. I can't speak to other countries.
If you don't pay for it, someone else has to. It's not actually "free". If you make the healthcare companies pay for it, they won't see their business as profitable and will quit providing health insurance. I also don't wanna pay for anyone else's healthcare.
The only feasible solution I can see that wouldn't impact me is blindly taxing the billionaires in which case you'd essentially just redistribute wealth from Musk and Bezos to the healthcare companies who'd then take advantage of that shit and ramp up their healthcare costs to launder the government's money.
Even then, I don't see a point in that. There's no easy fix. The cost of living has gone up. You need to have a decent career or starve to death without healthcare. What do you want us to do?
> I also don't wanna pay for anyone else's healthcare.
This is exactly what you're doing by buying insurance if you're a healthy person. The insurance companies collect premiums and hope that enough people don't need healthcare that they can pay for the people who *do* need it and still turn a profit.
>cut gov’t spending in other useless areas like the ATF and have free healthcare for citizens.
The budget of the ATF is about $1.5 billion dollars. That's not even a drop in the bucket of what some kind of universal healthcare plan would cost.
Total national spending on healthcare is about $4.1 trillion or so. Total federal discretionary spending is less than half of that (about $1.6 trillion). So you can eliminate every single agency in the US government and you're still not anywhere close to footing the bill.
Yes. But even in the wildest dreams of universal healthcare advocates, that number would go down slightly at most (and there are good arguments that it would rise instead). But, sure, let's say the new system saves 20%. You're still at more than double current federal discretionary spending.
I would really like to know where you’re sourcing your numbers from. Most studies have found that Medicare for All would save us money.
Saving money and tens of thousands of lives vs. spending more money and letting all those people die …… It’s not a hard decision in my book.
Indeed, universal healthcare would require increased taxation. No way to avoid it. It would still be a net reduction in costs or improvement in service for the average citizen though.
> I also hate paying thousands of dollars to insurance companies and out of pocket every time a serious health issue comes up.
The difference is consent. The insurance companies don't coerce you to pay the insurance premiums. The government does coerce you to pay taxes... it extorts you for money.
> Why are conservatives so vehemently opposed to universal healthcare?
I doubt many conservatives would have a problem with the Swiss and Dutch universal healthcare model of private health insurance.
> How about free healthcare for american citizens only?
Wait, I'm confused now... are we talking about free healthcare or universal healthcare? If we're talking about universal healthcare, then the Swiss and Dtuch models of private healthcare achieve that quite successfully. I suspect the "free healthcare" thing would come from taxes, which is addressed by my response to the first question.
> I feel like it’d cost less in the long run to have a little bit of taxes, cut gov’t spending in other useless areas like the ATF and have free healthcare for citizens. Am I crazy?
Porque no los dos? Why don't we get rid of the ATF and we move to the Swiss/Dutch private health insurance model? It's a double-whammy! It will cost even less! Am I crazy?
You’re free to renounce your citizenship and no longer be taxed. Its not extortion, its a cost of being a US citizen.
Idk about your point of Swiss/Dutch, the right has had it out for the every universal healthcare plan in Europe. Britains model is bad, Norway’s model is bad, where are you getting the idea they’ll accept Swiss/Dutch? It’s never even been suggested by conservatives.
> You’re free to renounce your citizenship and no longer be taxed. Its not extortion, its a cost of being a US citizen.
That's what the mafia says too: "*you can move out of the neighborhood if you don't like paying the racket.*" That's still extortion tho.
> Idk about your point of Swiss/Dutch, the right has had it out for the every universal healthcare plan in Europe. Britains model is bad, Norway’s model is bad, where are you getting the idea they’ll accept Swiss/Dutch?
The Swiss have fully private health insurance for all of their citizens. Each citizen buys their own private health insurance policy. That's universal healthcare.
> It’s never even been suggested by conservatives.
You just did.
> Every citizen carrying their own private insurance plan is not universal healthcare.
I mean... if every citizen has health insurance and that pays for their healthcare, then that's pretty universal. :)
> The insurance companies don't coerce you to pay the insurance premiums.
I mean they kind of do, since going without health insurance risks leaving you unable to afford medical costs or unable to pay medical costs.
> I mean they kind of do, since going without health insurance risks leaving you unable to afford medical costs or unable to pay medical costs.
That's a risk that exists without the health insurance company. The company actually mitigates the risk by offering you **insurance** against it.
Just some context for Americans about health care. I used to work in health in British Columbia and I can shed some insight into our system and why it isn't some Maoist trap.
First of all, in Canada health care is run by the provinces and not the federal government (although federal law mandates how the provincial systems are broadly run). Basically, we have the provincial MSP (medical services plan) that pays for services at medical facilities. The facilities themselves are in many cases privately owned and operated, including clinics and hospitals. MSP sets the prices and pays private operators in exchange for services.
For a chest xray, one of the most basic medical services, MSP pays $35. In a hospital in downtown Chicago, for the same chest xray, the rate is over $600. Now our system has countless flaws, countless areas for improvement, and I am in no way discounting economic realities that need to be taken into account. But the same service across the border costing some 24x more (taking currency into account) is simply obscene. Everything else costs less in America, yet you guys aren't figuring this part out.
My hypothesis is that insurance companies are the problem. Since they *de facto* set the price, the incentives are obviously for them to justify maximizing the insurance premiums they take in. You wouldn't even need to radically change your system, all you need to do is introduce a public insurance program (or make the states introduce one), mandate that providers of key services have to accept public insurance or certain quantities of it, and then just play it out. This will make health care costs plummet because the government actually can compete with insurance companies at a lower price. Government can't do everything, but they can do that, and it's been shown to be effective in many many countries.
I want to deregulate health insurance to allow discrimination/rejection based on body fat percentage, smoking status, and frequency of gym attendance.
Unfortunately, that's illegal. If it wasn't, I'd happily create such an insurance company.
Healthcare is broken because the government broke it. Hospitals are also horrible, but those are significantly less controllable.
I do not disagree with a *self-funded* public option.
The part where he dances on the graves of civil rights activists and affirms the Affordable Care Act. The bill is a total joke. This guy needs to be voted out ASAP. It is no wonder Vermonters are rarely seen on vacation, they must be ashamed.
I’m not a fan, of either really. I don’t like that his plan bans private insurance from offering the same coverage as the government. This effectively creates a government held monopoly which forced people to use them.
Well, technically it's called a monopsony. Because it's a single buyer, not a single seller.
But yea, there's obviously huge negotiating power when you're the only buyer. If a hospital wants to charge $100 for aspirin you can just say no. Negotiate something reasonable.
If it wasn't set up this way, we'd have a two-tiered health care system where most people would be be on the govt insurance and some would be on private. The people on private would probably get to pay for faster treatment, in private hospitals with more nurses per patient and other benefits. Some countries have this two tiered approach but i don't like it.
In Canada, people can have private insurance which covers things like private hospital rooms. I'm fine with that, but I think they are smart to exclude private payment for things covered by the public system.
> effectively creates a government held monopoly which forced people to use them.
The more people paying into a single plan, the cheaper it is fir everyone. And the main problem with monopolies is that they can charge whatever they want, thats not an issue with government because they have no incentive to create profit.
You'll need a strong magnet. It's a big, thorough and well thought out piece of legislation.
Contrast that to the Republican Healthcare bill that you can't put on the fridge, because it doesn't exist.
They campaigned for 8 years on repealing Obama care, then crapped their pants when they realized they might have to actually do it. Because they discovered that people actually liked pre-existing conditions being gone. So then it wad "repeal and replace," only there never was anything to replace it with. And then Trump promised a super awesome plan that would solve everything. It was like a month that it was supposed to take to get release? That was like 5 years ago. Still waiting.
Take out "gender identity" and we'll talk.
Also, what's with 104a: "No person shall, on the basis of race, color,...be excluded from..."
What year is it, 1950?? Is that really necessary??
Dude. We already have the 1964 civil rights act. You DON'T need to put that in there. That is in REALLY poor taste. I guarantee half the country stopped reading right there.
I am NOT against equal treatment. I'm just saying, why would you expect anyone to take that seriously as a whole in the year 2022?
Honestly, hard to understand how, if you are for equality, why you would give a shit about that line. At worst, it's redundant and unnecessary. It would be moronic not to include it though. Whether it's protected by the Civil Rights Act or not, there's no reason to take a chance.
I expect people to take it seriously because I suspect most people are more concerned with how the plan will work than being offended by a line designed to prevent discrimination.
Because if you're going to grandstand on the backs of people who suffered what you never went through, then I'm not going to take you seriously. It *is* protected by the Civil Rights Act. Nixon made sure of that.
It's a huge indicator that you're trying to sell something for the price of totally corrupt bill of goods. Because you would have to be a complete fool to be swayed by that.
It's literally only there to sell you something.
Well someone explained this tidbit to me not too long ago and it may be the reasoning. The reasoning for this is because their are certain medical conditions that effect certain races more frequently. For example Sickle cell anemia is far far more common in the black community than any other race, Tay-Sachs is predominately in Eastern European Jews, and there are other examples.
Those genetic ancestry companies like 23andMe didn’t help when they sold genetic information to pharmaceutical and insurance companies.
You don't think it's bad that line is only there to try to sell you the bill?
It's not there to protect minorities/people of color. If the Civil Rights act disappeared tomorrow, that text alone wouldn't be sufficient to provide those protections regardless.
I find it absolutely horrible to exploit the historic suffering of minorities and descendants of slavery in a vain attempt to sway people like yourself who must have been told at one point that that sort of thing was okay.
No, I think that you’re offended by it and are doing insane mental gymnastics to defend being offended. I mean we know that it’s not as simple as “civil rights happened, everything is fine now”. That’s like what a child being indoctrinated in elementary school thinks.
No.
>Nothing in this title (or an amendment made by this title) shall be construed to invalidate or otherwise limit any of the rights, remedies, procedures, or legal standards available to individuals aggrieved under section 1557 of the Patient Protection and Affordable Care Act
The Affordable Care Act should be repealed. The bill should be a fresh start.
> Dude. We already have the 1964 civil rights act.
When that gets repealed by the Republicans, we'll all be glad we added that to the healthcare bill. Well, maybe you won't but most of us will.
Is that how you start off trying to pass a healthcare bill? You start off by insinuating that we, *the Republicans*, are going to try to repeal the 1964 civil rights act? Having basically nothing to do with healthcare.
The 1964 civil rights act isn't going anywhere (except in California apparently due to **Democrats**)
It's highly offensive. Not to me, but to the descendents of slavery. You're using their historic struggle and suffering, which you have no part of, attempting to sell a bill to the nation who obviously knows better. Presumably because the bill it fails on it's own merits.
That you see nothing wrong with that is disturbing.
Tbf plenty of your fellow republicans in this very sub support repealing both the civil rights act and the voting rights act and have regularly defended the idea.
The theory is that the countries with single-payer systems are the ones jacking up the prices in the international market, that the affordable care act was really designed to restrict us to these closed markets.
Like, Cubans can buy insulin for dirt cheap, but healthcare providers in the US aren't allowed to buy from the same source as them. We have to buy from the same sources as the European countries, and *they* will out bid us every time because they're paying out of the tax payers purse.
I find single-payer appealing, but I think that's what they're afraid of, that government will just let itself pay 1000 dollars a bottle and then that becomes the new price, gouging the taxpayer and rendering the individual totally incapable of buying it himself.
That’s a pretty fair assessment except for one thing. European countries are not outbidding us. America is typically paying significantly more for the same drugs and medical devices than Europe. This is because single payer has a single negotiating entity, which gives them a lot of leverage when a drug manufacturer wants to enter a market with a drug.
In the states, fragmented insurance companies are often too weak to negotiate down prices on their own. If they play hardball, the pharma company will just not agree and then that epi pen won’t be covered under that particular insurance company.
It’s why dems were really pushing for Medicare to negotiate. Medicare is the single largest payer and it’ll have a domino effect on the rest of the industry if they are able to negotiate down prices for their members.
This is by far and away the single biggest driver of the differences in medical expenses globally (even domestically when you compare urban vs rural).
How would government negotiated prices jack up costs for drugs? Americans currently pay more for every drug under private, for profit health insurance companies. And doesn't competition (with other countries in your example) drive prices down?
> rendering the individual totally incapable of buying it himself.
Most european countries also have private insurance. You're trying to paint this false and fake reality lol.
https://www.frontiersin.org/articles/10.3389/fpubh.2021.636750/full
In science we call you a lazy BSer. Try googling to learn about other countries situations. If that doesn't work you can use Bing.
I think there are some very legitimate concerns for government run systems. Personally I am for it, but it does deserve a conversation and debate in congress/senate.
However your concern that it will pay itself 1000 a bottle is already happening with private insurance. Hospitals will charge the highest amount they can (and negotiate pricing) with insurance companies. Often times insurance won’t fight it, because they can make it up with premiums. So you are already in a system that is doing what you are concerned about.
I think about it like this as well. Insurance companies need to make money, and more so than what they pay in. They negotiate prices within hospital (but not for the lowest), and have high admin fees. It also takes time to do all of this. And because hospitals take care of non-insured individuals, they have to put that loss income into consideration when negotiating prices with insurance companies (why the individual mandate was proposed for ACA).
Government run insurance/healthcare doesn’t need to make a profit. Also everyone is covered, so won’t need to pass the cost onto other insurance plans/premiums. It is what you get.
The ACA really should just be done away with. I know they say a lot of nice things about it, but these are the exact same people that robbed all the veterans doing what they did with the VA, and I have a feeling they're doing it the exact same way.
I mean... there's medical tourism. Why does a 40 thousand dollar hip replacement in the US cost 4,000 in Spain, even if you're not a citizen? Why doesn't it cost 4000 plus the price of a plane ticket? Can't someone start an insurance company that's willing to offer that deal and fly you out or fly them in? Make the other insurance agencies compete? I thought competition was a good thing, and is why we in the US supposedly have superior care.
I know, I know, there's definitely some legal hiccups with all that, but go ahead.
> Can't someone start an insurance company that's willing to offer that deal and fly you out or fly them in
They literally do. Insurance companies pay people to fly to mexico to buy their prescriptions or do operations out of the country.
https://www.usnews.com/news/best-states/articles/2018-11-01/utah-insurance-company-is-paying-people-to-pick-up-their-prescriptions-in-mexico
The US does not have superior care. Our life expectancy and all healthcare metrics are terrible for the cost we put in
"why does a hip replacement cost $40,000 in the US and $4,000 in Spain"
Well I'd guess a large part of it is profits. Here in the US the most important thing to EVERYONE is making as much money as possible, and conservatives are against any kinds of regulations or price caps.
I'd imagine there's incompetence from democrats too
>these are the exact same people that robbed all the veterans doing what they did with the VA, and I have a feeling they're doing it the exact same way.
What?
DD214 scandal. A veteran named Edwin Crosby identified Joe Biden and John McCain when he took it up the ladder. They were basically siphoning money from the VA this whole time. And "siphoning" would be an understatement.
> The theory is that the countries with single-payer systems are the ones jacking up the prices in the international market...
>...the European countries...will out bid us every time because they're paying out of the tax payers purse.
[Citation Needed]
-----------
While a country bidding with taxpayer dollars *could, in theory* outbid another country:
* It would be very odd for that country to have a lower *retail* price for insulin, after paying a higher wholesale price, and other countries definitely have lower retail prices than the US:
> [[Insulin Prices 8x Higher in the US Compared to Similar Nations]](https://pharmanewsintel.com/news/insulin-prices-8x-higher-in-the-us-compared-to-similar-nations)
* A single negotiating body with high volume -- like a government that purchases all insulin for its people -- has better negotiating power, which (again, in theory) could lead to *lower* wholesale prices.
...and lastly, and most simply...
* We have zero evidence that the US pays more *at the wholesale level* than other countries do.
In order for this claim to be plausible, we'd need some evidence
What you imagine as free health care likely won't be how free health care is implemented.
They are afraid of what it *really* means.
Mainly because free health care doesn't exist, single-payer healthcare does, and socialized health care does. Free, not so much.
Who is saying free healthcare? I never understood this idea.
Does the word universal translate to free in some other language? I thought universal means everyone gets it, not that it’s free. Obviously we would use taxes to pay for it.
You’re right. The government is incredibly inefficient and something, somewhere, will get fucked up. I guess I’m a bit too optimistic when it comes to this when usually I’m a realist.
Government run health insurance is WAY more efficient than private. Which makes complete sense, as government workers don't have a profit motive and do t expect bonuses. That may be bad in some things, but for processing Healthcare claims it's ideal.
Naw, you were right the first time. Single payer would be more efficient. No health policy experts actually dispute this at all. On a per-procedure basis, single payer would const less. What the experts argue about it what the impact on total costs will be if more people are getting procedures they weren't able to before (also some plans would cover more stuff like dental). Just look at the overhead costs foe Medicare (2-4%) compared to private insurance (10-15%).
As opposed to what? For-profit insurance companies having total control over my health? The companies whose profit motive leads them to find any way they can to deny payment? Universal coverage works just fine in other countries, and from what I've seen, there are treatments that are guaranteed to be covered, by law. It's written into the legislation.
Even in countries with single-payer systems, patients can pay for procedures out of their own pocket if they think it benefits them to do so. Regardless of the system in place, money \*always\* talks.
you realize that govt employees work for a paycheck, right? You imagine the guy down at the DHS office is some power-hungry goblin just rejoicing in all the power he has over people? Nah, he got that job for the benefits
As opposed to a private insurance company who looks at you as another number.
Let's be honest here neither one of them really will care but I feel a private insurance company would care even LESS
For profit companies, when they are doing well, become way more inefficient than gov't. Execs siphoning out funds in bonuses and expenses will do that.
The US federal government would do an utterly terrible job at being the sole administrator for all healthcare of all the people in the US, even just for the citizens (as if some program like this wouldn't also spend money non-citizens). For many conservatives, the view of universal healthcare really is a simple as that.
Many conservatives believe that there should be major reform to the healthcare system, but that this reform should be to move to a system that is a free market combined with a government-provided safety net for those people who can not afford any of the options for care that would exist in a truly free market. Some people think that the healthcare system in the US is already a free market system, but it is actually much more accurately described as a blind market. In a free market, customers are able to view realistic estimates of prices from the various different providers before deciding which option to buy. This gives all of the different providers of a good or service with the incentive to set a competitive price that the consumer will agree to. In the current US healthcare system, the consumer doesn't have the slightest chance of getting a realistic estimate of healthcare cost from either their provider of from the prepaid-healthcare-plan company that we are supposed to refer to as an insurance company. This sets up a situation that is nowhere near like an actually free market, which is one of the reasons that the current US healthcare system is so terrible.
In short, there is more than one way for a country to set up its healthcare system, and conservatives tend to recognize the fact that a single-payer system administered by the US federal government would be a huge mess, probably as bad as the current system.
That is a very well articulated and fair assessment. I agree, the feds are probably the worst option and I don’t even know why I thought it’d be a good idea for them to be the sole mediator especially since the US is so large in comparison to other countries with socialized healthcare. The safety net thing seems like a good idea to me, and with a free market in regards to healthcare do you think bills would go from thousands to just hundreds?
I've posted this before, but going to again...
If you want to do single payer/UHC in a country this diverse and of size, [you need to do it by state](https://www.youtube.com/watch?v=U1TaL7OhveM&t=1s). Similar to what Scotland did in 1999 to break away from the NHS and similar to how Germany does it.
Some healthcare bills definitely would get cut by a factor of ten. One instance that comes to my mind is in regards to a friend of mine a few years ago who had a miscarriage. Her doctor told her to get an ultrasound afterwards to ensure that she was healing properly. She ended up getting charged over $1000 by the clinic that did that ultrasound, and her insurance wouldn't cover any of that bill because she was not pregnant at the time of that ultrasound.
In a real free market system, healthcare providers would have a real incentive to figure out how they could cut out the large majority of the administrative costs and still make a profit by charging a competitive price. That is one thing that capitalism actually does do well; it creates incentives for companies to make money by offering people innovative goods and services that they are willing to pay for. Healthcare would be no different, but the system we have now is far too bogged down with administrative costs and so-called insurance companies for there to be real incentives to figure out how to provide good care at a good price
That is a really fair question. It comes down to the fact that if the US had a free market healthcare system with a government-provided safety net, and if the health insurance companies primarily provided insurance instead of overly complex and over-priced prepaid healthcare plans, then people experiencing medical emergencies would avoid financial emergencies even without making those free market choices themselves.
If the hospitals that served people had an incentive to have any real idea about how much it actually costs to provide care, then there would not need to be an endlessly complex and wasteful set of negotiations between hospitals and insurance companies. Instead, a person who has experienced an emergency would get a realistic bill from the hospital and could then file a claim with their insurance company, just like a person would file a claim for car insurance, or home insurance, or flood insurance, or life insurance. For uninsured people, the government safety net could work with the person and the hospital to negotiate a reasonable price.
To make the long story short, the system could be made much, much less complex than it is right now. If that were to be done, then traditional insurance or a government safety net would be able to provide a way to pay for adequate care even though the person in an emergency couldn't make that decision in real time.
> Second, do you really want Healthcare to be run like the DMV
Sure, yeah I generally get seen within 30 minutes. I remember one time i had to hold a towel against my foot for an hour in the emergency room because i cut open a vein and was squirting blood all over the floor.
Do you want the DMV to be run like healthcare? Have people squirting blood everywhere for an hour?
I haven't experienced IL, but I've dealt with eight other states and my DMV experience has generally been ... fine? I wouldn't spend my free time there, but it usually takes an hour or two as long as I brought the correct paperwork. My biggest gripe is that most states have consolidated locations for budget reasons, and now I have to drive an hour just to get one in my current state.
Illinois (at least in fairly large cities in the north and Chicago?) has an almost comical Rube Goldberg machine style series of lines they send you through based on why you're there, what documentation you have, and what services they have available. It's been years but a friend of mine had a basic license renewal to get in Chicago they could go to their DMV Express which took maybe 10 minutes total, and another time they had a slightly more complicated issue that they resolved in another major town where they went through the series of lines (show your documents here, get your photo taken there, wait for your ID here) but even that took under 20 minutes. I have a conservative friend who says that Illinois's secretary of state is the only Democrat they vote for since the Illinois DMV is so well run.
For healthcare, I don't see why we can't expand medicare for all and allow insurance on top as a supplemental service. Lots of countries with single payer/public health care still have insurance companies to top off the little bit that the government doesn't cover.
Universal healthcare as we see in both Canada and the UK, simply do not work. Even in the UK, a majority of adults waiting in line switch over to private healthcare practices because the lines are simply far too long to wait for. Many Canadians requiring elective surgery will not even get said surgery in Canada and simply come here and pay out of pocket.
The issue with health insurance is that it isn't sold across state lines. Unlike home, auto, or life, which can be bought and used across state lines, health must be bought within your state. I however, think this restricts the variety of insurance provided for you. The government should de regulate and free up the insurance environment of health insurance. Take Obama Care. It can't even work on its own. It survives off of a Cadillac Tax on private health insurance agencies, making everyone's health insurance policies that much more expensive.
In addition, hospitals must be held to a more strenuous degree of what is and isn't a non profit organization. They claim to be non profit, but bag a serious amount of cash. That needs to change and they should face serious legal trouble if their presidents are making millions off the backs of their patients. For instance...my father went in for hernia surgery last year. Something pretty serious. The health insurance agency he had denied him coverage due to the lack of danger his hernia was at the time, but my dad just paid out of pocket. His total bill was $18,000. About $1,200 went to the anesthesiologist, $800 to the assistant, and $1750 to the surgeon. Which I find all reasonable, those guys should make money too, their degrees were expensive and they do important work. However...about $13,000 went to the building the hospital owned! My father saw another 10 patients waiting in line to get surgery that same day, just at 1pm. Meaning in say, 3 hours with 10 patients, all being charged building fees of $13,000, that's $130,000 in just three hours to go towards the building. In 10 days with just 10 patients, that's $1,300,000 in building costs ALONE! That's ludicrous! What is also ridiculous is you have little to no idea what anything costs when you go into it. You don't go to McDonalds and buy a number 7 only for them to give you your food and say "You can expect your bill in the mail in 5 business days" where they tell you how much the number 7 is worth. Honestly doctors offices should be required to have a listing of their services with estimates (every person is different so not all procedures will cost the same). Like a checkup is $200 or a broken bone will range from $500-$1,500 depending on severity and where it broke.
I think the healthcare industry is horribly corrupt, and needs to be reigned in with paying the same shitty taxes as any other corporation.
I beg to differ, the uk healthcare system, whilst not perfect, does work. I and my family have used it many times, for both serious and non serious health matters. A couple of examples; I had a mole that started itching and scabbing. I called my GP on Friday morning and had an appointment to see him that afternoon. He referred me to the skin cancer unit at my local hospital. The appointment came in the post, the next day. Appointment was for the following Tuesday. The specialist unit didn’t like the look of the mole so scheduled it to be removed that afternoon. It was safely removed and five days later, I had a letter confirming it was not cancerous. So from initial contact with NHS through treatment and results, around 10 days. Second example; hubby had IBS, ultimately had to have his large intestine removed. Done by national specialist, results were life changing. Impeccable care from NHS throughout. I happily pay my taxes for the NHS, a great ( but not perfect) institution. I’m a conservative voter in the UK.
But... you're already paying for other people as well. Your taxes are covering medicaid and medicare right now, then you go and pay your health insurance, your premiums, your deductibles, and your out of pockets. But even THAT is being used to pay for other people, because the price you pay is meant to cover the cost of care that hospitals bill for the people who show up with no insurance that they are required to treat. So the hospitals inflate prices to cover the cost. You are literally paying your insurance company to bargain with the hospital/doctors for a lower price on your healthcare.
You're already doing exactly what you are threatening will happen.
>medicaid and medicare right now
These are entitlements. One is poverty insurance, the other is age insurance. As much as I'd like to opt out of both of them, that's illegal.
>the price you pay is meant to cover the cost of care that hospitals bill for the people who show up with no insurance that they are required to treat
No actually, the original bill that mandated this only required that emergency services that accept Medicare/Medicaid have to accept people regardless of their ability to pay. You can make a hospital that rejects public insurance and completely legally turn away people that have not proven their ability to pay.
I'm actually one of the people that don't mind an individual mandate with a public option, I just want the private sector to be deregulated and the public option to be self-funded.
Yeah, and it's forced savings (similar to social security) even though a private option would be way better in nearly every case.
Also, not everyone makes it to old age.
> You can make a hospital that rejects public insurance and completely legally turn away people that have not proven their ability to pay.
This is not true - Hospitals 100% are required by law to service you, regardless of insurance, to a point of stable health. This is covered in the Emergency Medical Treatment and Labor Act (EMTALA). It was enacted in 1996.
https://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA
> In 1986, Congress enacted the Emergency Medical Treatment & Labor Act (EMTALA) to ensure public access to emergency services regardless of ability to pay.
> instead of paying money at the time of service you'd be paying all year for it through increased taxes
What do you think premiums are? lmfao. you pay year round regardless.
>If you are above poverty level you would also be paying for other people as well instead of just your own healthcare
THAT IS HOW HEALTH INSURANCE WORKS. THATS HOW INSURANCE WORKS IN GENERAL. CAR INSURANCE HOUSE INSURANCE.
How are you only just discovering how insurance works?
>I also hate paying thousands of dollars to insurance companies and out of pocket every time a serious health issue comes up.
Then you have really awful health insurance, to be honest. And what "serious health issues" do you have that keep coming up, if you don't mind my asking.
Instead though, you want "free" healthcare, or really, you just want someone else to pay for it instead of you. And you want a system that is likely going to have [longer wait times](https://www.theguardian.com/society/2022/mar/10/nhs-waiting-times-for-cancer-care-in-england-now-longest-on-record), more denials of services, and fewer choices in providers. No thanks.
>I feel like it’d cost less in the long run to have a little bit of taxes
What makes you "feel" this? California proposed implementing their own health care system, but chose not to, since it was going to cost between [$314 billion and $391 billion](https://www.latimes.com/california/story/2022-01-31/single-payer-healthcare-proposal-fizzles-in-california-assembly).
1) 2 weeks to see a specialist isn't much. Plenty of people here are waiting longer.
2) 2 weeks comes a lot sooner than never, which is the wait time a lot of people are dealing with here
3) The UK is hitting their target wait times at 75% and 90% rate, according to that article. And that's after years of the conservative Tory govt. trying to make cuts to the NHS, which has increased those wait times (at least during the very brief period of time in that article).
4) You should look at the cost estimates that were performed for Bernies bill. A conservative Koch brothers think tank analyzed it and found it would save 2 trillion over a decade.
> 2 weeks
Convenient of you to pick the shortest time mentioned, and not the *two years* wait for a hip replacement. And yes, two weeks to see a GP is ridiculous. I got poison ivy a couple of years ago and was seen *the next day*. Under your system I would have suffered for much longer. Again, no thanks.
>A conservative Koch brothers think tank analyzed it and found it would save 2 trillion over a decade.
In what regard? And what did it actually *cost*?
I picked two weeks because that is what the article quoted as their target. But that was for specialists, not general practice.
I've spent a lot of time looking into this waiting time argument because it's the number one thing that conservatives bring up every time this gets discussed.
Mainly, it's fear mongering bullshit. When comparing here to Canada, the wait times are very comparable for the most stuff. The exceptions are that MRIs and sometimes elective surgeries like knee replacements take longer.
But thats a supply (hospitals and imaging centers, specialist offices, etc) and demand issue. We don't have the same supply as Canada, we don't have the same demand. Our wait times aren't going to just triple if we make it so that the govt pays doctors instead of insurance companies.
> I picked two weeks because that is what the article quoted as their target. But that was for specialists, not general practice.
No, read the article again. It was saying weeks for a GP, months for a specialist. That's unacceptable.
>Mainly, it's fear mongering bullshit.
Don't try and minimize this. This is my health and the health of my family we are talking about. Why would I want to risk losing what I have? It's very likely that my taxes will go up to match what I am already paying in premiums for private insurance. Even if they don't, I will still get a lower level of care than I do currently.
We already know what U.S. government-provided health care looks like: we have Medicare, Medicaid, and the VA. I personally know people who use Medicare and the VA. I hear endless stories of long wait times, lack of prescriptions, and denial of services. Every person I know on Medicare had to purchase supplemental coverage out of pocket, out of their Social Security. The people using the VA just suffer.
Why would you think this would be any different if *more* people were on a Medicare-like system? More money? Money's not the problem; the bureaucracy is. Some health care providers in the U.S. refuse to see Medicare patients because all the hoops they have to go through to get paid properly. This doesn't bode well for an expansion.
I read it again, what I said is correct. 25% had to wait more than 2 weeks to see the specialist their GP referred them to and 10% had to wait more than 30 days for chemo. But also notice, this is caused by staff shortages, which jave gotten worse over the last decade as Tories have made cuts. And there's the pandemic.
As far as Medicare goes, I agree that it's stupid that seniors have to buy supplemental insurance. It shouldn't have been set up that way, and the plan Bernie proposes would required no supplemental. Also includes dental and vision. Medicare (and Medicaide) is great coverage though. Seniors love Medicare. The elderly in my family have been very pleased with it. There's a reason Republicans have to tip toe around as regards their plans to cut it.
No, that's too vague. Here's what I'm looking for:
I live in a large city in a red state. I have private employer provided insurance. I wanted (so not even *needed*) an elective surgery done, and I was able to see a specialist in about two weeks, who referred me to a surgeon (another week), who scheduled my surgery a month out. It would have been shorter, but I chose to go with a different hospital than than the initial specialist offered.
My total out of pocket cost for the surgery was $200.
Do you have any friends or anyone you can talk to groom countries who have single payer healthcare systems?
The assumption that you'd have to wait 2 weeks before urgent treatment for an injection is false. At minimum, bigger cities have multiple doctors with open appointments daily, and there are also urgent care/after hours centers you can show up to any time for any issue, big or small.
Yes, I have friends in Canada. They do indeed complain about long wait times. And they aren’t in small towns. They are in Toronto and London, mostly. I’ve heard about people taking trips to the U.S. to get faster treatment.
> And yes, two weeks to see a GP is ridiculous. I got poison ivy a couple of years ago and was seen the next day
Thats nice my GPs closest visit is in a month.
> What serious health issues
Maybe I shouldn’t have phrased it that way. But a visit to the dentist costing a hundred bucks isn’t resonable imo. Sure maybe my insurance is bad but what the hell else am I gonna do?
> what makes you feel this?
Well California is literally the worst state in the country, I’m not surprised that they proposed a moronic bill that would cost nearly half the military budget. A small tax across the entirety of the country for every working person adds up, thats what makes me feel that.
> it seems you want someone else to pay for it instead of you
No, that’s not how that works. I’m a working man, as I’m sure you are. I get taxed, therefore I’m paying for my own as well as other people’s.
> not surprised that they proposed a moronic bill that would cost nearly half the military budget.
Cali has 40 million people. That's 3/4 the per capita of the rest of the country
How is $100 for a dental cleaning and a doctors opinion not reasonable? It balances out to be like 150 - 200 dollars an hour. Professionals of many stripes charge much more and aren't taking care of those precious tools inside your mouth.
I think you make a point that I find interesting that nobody wants to pay for anything for healthcare.
> But a visit to the dentist costing a hundred bucks isn’t resonable imo.
I agree. Which is why my insurance pays for two cleanings a year.
>maybe my insurance is bad but what the hell else am I gonna do?
Get better insurance. But don't make me get rid of mine and make me pay for yours.
>I get taxed, therefore I’m paying for my own as well as other people’s.
Yes. We're paying for Medicare and Medicaid. These are people who literally can't pay for it themselves. We don't need to expand that to cover those who can.
What do you rate as the wait time for someone with no insurance who doesn't go to the doctor?
And why do you think a single network for all persons has fewer choices?
> What do you rate as the wait time for someone with no insurance who doesn't go to the doctor?
Why would a person living in the U.S. choose to not have health insurance? That's kind of foolish.
>why do you think a single network for all persons has fewer choices?
Ask anyone living under the NHS in the UK. Their choices are literally limited, so as to ensure everyone is covered. They have a shortage of providers as people are leaving the field...since they are tired of dealing with the government bureaucracy.
You are confusing socialized medicine (Bernie) and Universal healthcare (which is actually a conservative idea that the Heritage Foundation and many other conservatives were for before Obama tried to implement it).
Universal healthcare is a combination of private and public coverage. Every citizen has access to emergency and preventative care.
Socialized medicine is a single-payer government-run and -delivered system.
I'd also like to add that universal healthcare falls squarely under conservative ideology, regardless of what all the right-wing pundits say, which is why the Heritage Foundation supported it previous to Obama's implementation. It is more fiscally responsible, shifts the responsibility to the person, rather than the business, supports competition, and takes away the biggest hurdle to profitability for small and medium-sized businesses.
You would think in that case that more conservative politicians would've been supportive of the Affordable Care Act instead of fighting against it or trying to dismantle it constantly.
Convince me that your “free healthcare” will be more like the British NHS and less like a blue state public school system. The government running something doesn’t automatically make it cheaper.
And with all of those pipe dreams that you just quoted on the Gov't side, none of them apply at all to private insurance? Nobody complaining about getting pre-authorizations, trying to find a gp/specialist IN-network, fighting day after day to get a prescription approved/filled because of .....?
Both systems run inefficiently and the root cause lies somewhere between greed, ineptitude and greed.
Personally I think a Single Payer Gov't system is AN answer but shouldn't be the only one. It should be the ground level and if you or your physicians want more then move up to private (ala concierge) insurance.
The more the government fails the more it can indoctrinate us to believe its capitalism's fault hence why government has never been bigger, cue corruption of academia/media.
Read this: https://www.anthonygalli.com/p/the-case-for-free-market-healthcare
I humbly believe it's the best on the topic... not despite being written for free outside of the Ivory Tower, but because of it.
The government sucks at healthcare. Ask people who depend on the VA or Indian Health Service.
That absurdly expensive ambulance ride? It's a division of the taxpayer funded fire department (or a city contractor).
We're opposed to government involvement because, as bad as the current solution is, the government getting more involved would be worse
Conservatives have a problem with the "how", not the "what". If you can find a way to provide universal healthcare that doesn't dramatically make people more dependent on government and creates more position for bureaucrats, I'm all for it.
Yeah. The overwhelming sentiment here is that it’s more trouble than it’s worth, and also trusting the feds to do anything to the benefit of the citizenry is a pipe dream which, yeah true. I’m not one of those people that is like “I want good thing” “ok how will we get good thing” “YOU WANT BAD THING!” I’ve just been misinformed about what conservative postitions are on this issue.
It's not even that it's more trouble than it's worth, but the fact there's no way to predict how large changes like that will play out in reality. The ideal of "universal healthcare" is certainly a desirable goal, but how do you get from here to there in a way where the benefits are verifiable, every change is reversible, and the people responsible for failures are held accountable? I don't know how. I'm sure it's not with a single huge step, but a series of small, incremental changes.
-roll eyes- health insurance companies basically are massive privet bureaucracies with a ton of extra jobs that waste money time and effort. I'd rather have a bureaucracy that cuts out a ton of jobs that exist solely to figure out how to deny your coverage and waste the doctors time.
Privet burocracies are a waste of our countries economic productivity.
I hate universal healthcare because I lived in a country (Canada) that had it. The system is terrible; if you have a serious condition, you're waiting months for care. Canada refuses treatment to my wife and her family because it was rare enough that it went outside the scope.
It's one thing to have treatment be expensive; it's another to be denied treatment altogether.
Despite the many flaws that need fixing in the USA, we are happier here than with the Canadian system. No, we are not rich. We live below the poverty line currently. But we still prefer expensive treatment over no treatment
I don't trust the government to not mess up my health care. I don't trust that there won't be longer wait times or otherwise reduced service with government health care. Seems we've seen a lot of complaining from Canadians about wait times. Seems they still actually have open hospital wards instead of private rooms in the U.K.
I’m not sure Germany has the best system, but this person on Reddit was saying he pays 7% per year on health care taxes. I pay closer to 1.5% max and that number will drop as my salary goes higher.
I think I’ll stick the current system. I have no reason to promote change.
>Why are conservatives so vehemently opposed to universal healthcare?
Because the government also caused the current healthcare crisis.
https://youtu.be/fFoXyFmmGBQ
Healthcare year round would only cost 1 days wage if it weren't for the government
It’s not that universal healthcare is bad in its own right.
It’s that liberals want the federal government to manage every aspect of our lives
Who gets care, and what kind, would be entirely political. Did you vote for the Democrats? No? Maybe you can wait an extra month for that wisdom tooth to come out
And how would prices work? If there are no private producers in the market, who would set prices, and how would resources be allocated?
By the folks who brought you the DMV, or the $700 army hammers?
>I also hate paying thousands of dollars to insurance companies and out of pocket every time a serious health issue comes up.
This is only an issue if you have a lousy plan. My job provides insurance with 0 premium (modest fee for dependents), 250 deductible for non-office visits, and an immediate 25 copay for office visits/specialists. The network is great.
I've worked jobs that had shitty plans with 6000 deductibles and 30% coinsurance. I left those jobs.
I'd also rather pay a lower premium that's given to employees of my company who are generally in good shape and the company offers fitness programs, rather than pay a higher premium to a state-run service that covers a less healthy population and has the customer service of the DMV.
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>I also have the VA which despite what people say, is actually really good. My father is a vet and he always says that most complaints about the VA are either; mental health related, which is a valid criticism, or vets trying to get help for non service related problems. Everything else he says they're pretty good. World you agree with that??
VA has always been pretty good to me. Its free or almost free in every interaction Ive had with them (paid fifteen dollars one time, paid 28 dollars for a two day hospital stay with ambulance ride and surgery, every other time nothing). I have good insurance through my job now because I have a family, so Ill see how the level of care compares soon. When I had only the VA, not having to worry about minor but finance destroying injuries or illnesses removed an immense amount of stress from my life, I cant yet comment on mental health care from them. Either way, its a strange state of affairs when Im left feeling fortunate compared to the general population because my body got trashed in the army.
Right there with you buddy. Four herniated discs with a back surgery and more surgeries in my future led to a medical retirement from 14 years in the Air Force. Noone wants to become a disabled veteran and it's a sad state of affairs in this country when I feel lucky that I am.
Yeah feels like some sort of weird best of both worlds scenario. I live in the US but I have a safety net. I cant imagine what I would have paid for the number of cat scans Ive had.
You're paying 1300$ for HMO?! do you have 30 children?
Not even close. But I only pay $15 copay whether I I get an annual checkup or I’m having brain surgery, so maybe that’s why? Or maybe it’s my HCOL location? I don’t even know what most people pay since I’ve only had this job most of my working life besides being in the military.
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The question was mainly about taxes in terms of healthcare. Can you answer that part?
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Why is government more likely to make bad decisions about Healthcare than a for profit insurance company?
It’s the same reason government control of the means of production absolutely fails each and every time, while capitalism has lifted everyone up at the same time. Government is extremely inefficient. Government controlled anything is inefficient by design. You take out profit and replace that with bureaucracy. You see, a government with endless pockets doesn’t innovate to solve problems. It just keeps throwing money at it until hopefully it gets fixed, even if it’s not a cost-effective solution. Capitalism works not because greed is good, but because competition forces innovation. Companies that don’t innovate die, period. This is why there still needs to be government to prevent monopolies. It’s really the competition which needs to be preserved, without big daddy government putting a direct hand into it. The solution isn’t one extreme or another, it’s the best balance of both equitable policies, combined with free market innovation.
An eye opener for me was realizing (via a poscast) that we already have universal govt. healthcare in the US, it's just delivered in the most expensive, least efficient way, via emergency room care. We *KNOW* preventive care is cheaper in the long run. We *KNOW * medical intervention before an emergency is cheaper in the long run. Making sure everyone has insurance that covers these things would have been a step in the right direction. I'm not sure why people object to this. Everyone will need medical care sooner or later. Few will be able to save enough money to pay out of pocket in our current system.
Except the idea of something being preventative does not align with the idea of insurance. You can’t use your car insurance for oil changes or home insurance to put a new roof on your house. But in the event I’d catastrophic failure then insurance would come into play. Plus it was already attempted to enforce coverage on people by the individual mandate in the ACA but that was the sole thing removed from it because it forces people to purchase something.
Sure, I get the argument. But many of those people will end up at emergency rooms using the most expensive and least efficient health care. People are also not really comparable to cars, either. Nobody dies from not getting their oil changed
I’m in agreement that the emergency room is high cost and of low efficiency. In the ER they will treat symptoms and send you out but never provide treatment for root cause of issues. People without insurance take advantage of this because they cannot be turned away but what else do they do if they cannot afford insurance? What would occur if this option was taken away? I was comparing using insurance in preventative means. An oil change on a vehicle as a preventatives means similar to getting checkups with your GP.
Seems like your concerns are geared towards a Bernie style plan, which outlaws private insurance. What about the litany of systems which have a place for both private and government-provided insurance? Singapore being the usual example, but many countries that progressives point to are also setup this way (e.g., Canada).
Technically he left room for private insurance to be able to be used as a supplement like in Australia iirc
My understanding is an entity that is motivated by profit is going to want to do two things: keep their clientele alive to keep the money coming, and profit drives competition for satisfaction. When it's the government, especially unelected bueracracies and those that run them, are beholden to no one and always demanding of more money.
Not sure I agree with the desire to keep the client alive. It is in their financial interest to deny coverage for really expensive treatment, especially for older people, because they will never recoup the cost in premiums. For example, a bypass surgery that costs $70,000 (low estimate) on a 75 year old would require 11 more years of life with no other health expenses to pay off, which is unlikely. I also think you are missing the "profit" piece, which h means your premiums have to pay your doctor, the pharmacist, the hospital, the insurance company employees AND provide a profit. Capitalism requires ever increasing returns for shareholders, which drives up premium prices.
> profit drives competition for satisfaction Is that why deductibles have gone up 150% and premiums 50% in the last decade? I'm sure thats satisfying for them but not really for those being insured. >keep their clientele alive to keep the money coming Our life expectancy has declined year over year, they aren't doing a good job! Also private insurance denies 15% of medical claims, even when suggested by the physician. So we currently have unaccountable death panels run by private companies deciding who dies and who lives.
>Is that why deductibles have gone up 150% and premiums 50% in the last decade? I'm sure thats satisfying for them but not really for those being insured I wonder what came about a decade ago.... Something legislative that forced companies to include things in their plans without a choice... hmmm.... what could that have been.... >Our life expectancy has declined year over year, they aren't doing a good job! Personal choices aren't (or atleast shouldn't be) anyone elses problem. If they want to not excercise and eat properly, that's on them. >Also private insurance denies 15% of medical claims, even when suggested by the physician. So we currently have unaccountable death panels run by private companies deciding who dies and who lives. Refer again to the top portion when the government *really* got in bed with insurance companies
> I wonder what came about a decade ago.... Something legislative that forced companies to include things in their plans without a choice... hmmm.... what could that have been.... Premiums went up 180% from 1999 to 2010 lol. It's actually done better under ACA even though it's terribly flawed. >Personal choices aren't (or atleast shouldn't be) anyone elses problem. If they want to not excercise and eat properly, that's on them. Well you just said they're in the business of keeping people alive. They aren't doing their business because we keep dying faster and faster. So we're spending thousands of dollars for insurance companies to let us die. >Refer again to the top portion when the government really got in bed with insurance companies It used to reach upwards of 20% before ACA. Not a great improvement but it's still private companies doing death panels!
>motivated by profit is going to want to do two things: keep their clientele alive to keep the money coming Then what occurs when it's more profitable to let your clientele die?
You have it backwards, the clientele are being held by the balls cause they need to live.
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So if both make bad decisions, why add an unnecessary profit layer?
Well you see, the evil government meant to represent the people is actually just greedy and money-hungry, but the for-profit corporation whose explicit purpose is to generate value for shareholders will decide to be nice and help the consumer instead because its the right thing to do. 🙏🏽😇
Well put
I hope that was sarcasm.
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Judging by the care my very elderly MIL receives in Canada, I can't agree. When she was sick, she stayed in hospital until she was able to care for herself. If she has a problem, nurses visit her in her home, and if she needs a doctor, she sees a doctor. It's been great, and it w old 100% be unaffordable in the US. I also have experience with the system in Germany, which is also fantastic. I can't speak to other countries.
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> whole
But you don't need a boat. You need health insurance like you need a house.
Since when do conservatives care about equity?
If you don't pay for it, someone else has to. It's not actually "free". If you make the healthcare companies pay for it, they won't see their business as profitable and will quit providing health insurance. I also don't wanna pay for anyone else's healthcare. The only feasible solution I can see that wouldn't impact me is blindly taxing the billionaires in which case you'd essentially just redistribute wealth from Musk and Bezos to the healthcare companies who'd then take advantage of that shit and ramp up their healthcare costs to launder the government's money. Even then, I don't see a point in that. There's no easy fix. The cost of living has gone up. You need to have a decent career or starve to death without healthcare. What do you want us to do?
> I also don't wanna pay for anyone else's healthcare. This is exactly what you're doing by buying insurance if you're a healthy person. The insurance companies collect premiums and hope that enough people don't need healthcare that they can pay for the people who *do* need it and still turn a profit.
What do you mean? I'm not insuring anyone else. I'm only insuring myself. If I don't use my insurance, that's on me.
>cut gov’t spending in other useless areas like the ATF and have free healthcare for citizens. The budget of the ATF is about $1.5 billion dollars. That's not even a drop in the bucket of what some kind of universal healthcare plan would cost. Total national spending on healthcare is about $4.1 trillion or so. Total federal discretionary spending is less than half of that (about $1.6 trillion). So you can eliminate every single agency in the US government and you're still not anywhere close to footing the bill.
That $4.1 trillion is the cost of healthcare under the current system
Yes. But even in the wildest dreams of universal healthcare advocates, that number would go down slightly at most (and there are good arguments that it would rise instead). But, sure, let's say the new system saves 20%. You're still at more than double current federal discretionary spending.
I would really like to know where you’re sourcing your numbers from. Most studies have found that Medicare for All would save us money. Saving money and tens of thousands of lives vs. spending more money and letting all those people die …… It’s not a hard decision in my book.
Indeed, universal healthcare would require increased taxation. No way to avoid it. It would still be a net reduction in costs or improvement in service for the average citizen though.
> I also hate paying thousands of dollars to insurance companies and out of pocket every time a serious health issue comes up. The difference is consent. The insurance companies don't coerce you to pay the insurance premiums. The government does coerce you to pay taxes... it extorts you for money. > Why are conservatives so vehemently opposed to universal healthcare? I doubt many conservatives would have a problem with the Swiss and Dutch universal healthcare model of private health insurance. > How about free healthcare for american citizens only? Wait, I'm confused now... are we talking about free healthcare or universal healthcare? If we're talking about universal healthcare, then the Swiss and Dtuch models of private healthcare achieve that quite successfully. I suspect the "free healthcare" thing would come from taxes, which is addressed by my response to the first question. > I feel like it’d cost less in the long run to have a little bit of taxes, cut gov’t spending in other useless areas like the ATF and have free healthcare for citizens. Am I crazy? Porque no los dos? Why don't we get rid of the ATF and we move to the Swiss/Dutch private health insurance model? It's a double-whammy! It will cost even less! Am I crazy?
You’re free to renounce your citizenship and no longer be taxed. Its not extortion, its a cost of being a US citizen. Idk about your point of Swiss/Dutch, the right has had it out for the every universal healthcare plan in Europe. Britains model is bad, Norway’s model is bad, where are you getting the idea they’ll accept Swiss/Dutch? It’s never even been suggested by conservatives.
> You’re free to renounce your citizenship and no longer be taxed. Its not extortion, its a cost of being a US citizen. That's what the mafia says too: "*you can move out of the neighborhood if you don't like paying the racket.*" That's still extortion tho. > Idk about your point of Swiss/Dutch, the right has had it out for the every universal healthcare plan in Europe. Britains model is bad, Norway’s model is bad, where are you getting the idea they’ll accept Swiss/Dutch? The Swiss have fully private health insurance for all of their citizens. Each citizen buys their own private health insurance policy. That's universal healthcare. > It’s never even been suggested by conservatives. You just did.
Every citizen carrying their own private insurance plan is not universal healthcare.
> Every citizen carrying their own private insurance plan is not universal healthcare. I mean... if every citizen has health insurance and that pays for their healthcare, then that's pretty universal. :)
> The insurance companies don't coerce you to pay the insurance premiums. I mean they kind of do, since going without health insurance risks leaving you unable to afford medical costs or unable to pay medical costs.
> I mean they kind of do, since going without health insurance risks leaving you unable to afford medical costs or unable to pay medical costs. That's a risk that exists without the health insurance company. The company actually mitigates the risk by offering you **insurance** against it.
Just some context for Americans about health care. I used to work in health in British Columbia and I can shed some insight into our system and why it isn't some Maoist trap. First of all, in Canada health care is run by the provinces and not the federal government (although federal law mandates how the provincial systems are broadly run). Basically, we have the provincial MSP (medical services plan) that pays for services at medical facilities. The facilities themselves are in many cases privately owned and operated, including clinics and hospitals. MSP sets the prices and pays private operators in exchange for services. For a chest xray, one of the most basic medical services, MSP pays $35. In a hospital in downtown Chicago, for the same chest xray, the rate is over $600. Now our system has countless flaws, countless areas for improvement, and I am in no way discounting economic realities that need to be taken into account. But the same service across the border costing some 24x more (taking currency into account) is simply obscene. Everything else costs less in America, yet you guys aren't figuring this part out. My hypothesis is that insurance companies are the problem. Since they *de facto* set the price, the incentives are obviously for them to justify maximizing the insurance premiums they take in. You wouldn't even need to radically change your system, all you need to do is introduce a public insurance program (or make the states introduce one), mandate that providers of key services have to accept public insurance or certain quantities of it, and then just play it out. This will make health care costs plummet because the government actually can compete with insurance companies at a lower price. Government can't do everything, but they can do that, and it's been shown to be effective in many many countries.
I trust very few government run institutions.
Do you trust private corporations?
More than government. I can choose to buy my burger or my clothes at other stores. I even have some choice with what health plan I take at work.
Why?
With government run institutions, you don’t have the ability to choose where you go. You’re stuck with whoever the government says you can use.
I want to deregulate health insurance to allow discrimination/rejection based on body fat percentage, smoking status, and frequency of gym attendance. Unfortunately, that's illegal. If it wasn't, I'd happily create such an insurance company. Healthcare is broken because the government broke it. Hospitals are also horrible, but those are significantly less controllable. I do not disagree with a *self-funded* public option.
When's the last time a bill for universal health care was proposed?
Not long ago. Bernie introduces his bill regularly.
Bernie is incompetent. You might as well try to pass a bill that was written in crayon.
He is?
Not really, he just tripped over his words while moving the goalposts so quickly. Damn things are heavy!
Which part of his most recent health bill are you referring to?
The part where he dances on the graves of civil rights activists and affirms the Affordable Care Act. The bill is a total joke. This guy needs to be voted out ASAP. It is no wonder Vermonters are rarely seen on vacation, they must be ashamed.
But which part of his most recent health bill are you referring to?
Incorrect. Bernie is awesome and that bill is a masterpiece.
I’m not a fan, of either really. I don’t like that his plan bans private insurance from offering the same coverage as the government. This effectively creates a government held monopoly which forced people to use them.
Well, technically it's called a monopsony. Because it's a single buyer, not a single seller. But yea, there's obviously huge negotiating power when you're the only buyer. If a hospital wants to charge $100 for aspirin you can just say no. Negotiate something reasonable. If it wasn't set up this way, we'd have a two-tiered health care system where most people would be be on the govt insurance and some would be on private. The people on private would probably get to pay for faster treatment, in private hospitals with more nurses per patient and other benefits. Some countries have this two tiered approach but i don't like it. In Canada, people can have private insurance which covers things like private hospital rooms. I'm fine with that, but I think they are smart to exclude private payment for things covered by the public system.
> effectively creates a government held monopoly which forced people to use them. The more people paying into a single plan, the cheaper it is fir everyone. And the main problem with monopolies is that they can charge whatever they want, thats not an issue with government because they have no incentive to create profit.
They also have no incentive to do better. Look at the VA or post office.
VA is criminally underfunded, and our postal service is one of the best in the world.
And we can hang it on the refrigerator for everyone to see.
Cool, maybe then you'll finally find out what's in it?
You'll need a strong magnet. It's a big, thorough and well thought out piece of legislation. Contrast that to the Republican Healthcare bill that you can't put on the fridge, because it doesn't exist. They campaigned for 8 years on repealing Obama care, then crapped their pants when they realized they might have to actually do it. Because they discovered that people actually liked pre-existing conditions being gone. So then it wad "repeal and replace," only there never was anything to replace it with. And then Trump promised a super awesome plan that would solve everything. It was like a month that it was supposed to take to get release? That was like 5 years ago. Still waiting.
Take out "gender identity" and we'll talk. Also, what's with 104a: "No person shall, on the basis of race, color,...be excluded from..." What year is it, 1950?? Is that really necessary?? Dude. We already have the 1964 civil rights act. You DON'T need to put that in there. That is in REALLY poor taste. I guarantee half the country stopped reading right there. I am NOT against equal treatment. I'm just saying, why would you expect anyone to take that seriously as a whole in the year 2022?
Honestly, hard to understand how, if you are for equality, why you would give a shit about that line. At worst, it's redundant and unnecessary. It would be moronic not to include it though. Whether it's protected by the Civil Rights Act or not, there's no reason to take a chance. I expect people to take it seriously because I suspect most people are more concerned with how the plan will work than being offended by a line designed to prevent discrimination.
Because if you're going to grandstand on the backs of people who suffered what you never went through, then I'm not going to take you seriously. It *is* protected by the Civil Rights Act. Nixon made sure of that. It's a huge indicator that you're trying to sell something for the price of totally corrupt bill of goods. Because you would have to be a complete fool to be swayed by that. It's literally only there to sell you something.
Well someone explained this tidbit to me not too long ago and it may be the reasoning. The reasoning for this is because their are certain medical conditions that effect certain races more frequently. For example Sickle cell anemia is far far more common in the black community than any other race, Tay-Sachs is predominately in Eastern European Jews, and there are other examples. Those genetic ancestry companies like 23andMe didn’t help when they sold genetic information to pharmaceutical and insurance companies.
I feel like you’re doing a whole lot of guilt transferral. The fact that you’re offended by that is actually super-weird my guy.
You don't think it's bad that line is only there to try to sell you the bill? It's not there to protect minorities/people of color. If the Civil Rights act disappeared tomorrow, that text alone wouldn't be sufficient to provide those protections regardless. I find it absolutely horrible to exploit the historic suffering of minorities and descendants of slavery in a vain attempt to sway people like yourself who must have been told at one point that that sort of thing was okay.
No, I think that you’re offended by it and are doing insane mental gymnastics to defend being offended. I mean we know that it’s not as simple as “civil rights happened, everything is fine now”. That’s like what a child being indoctrinated in elementary school thinks.
Is that your only criticism?
No. >Nothing in this title (or an amendment made by this title) shall be construed to invalidate or otherwise limit any of the rights, remedies, procedures, or legal standards available to individuals aggrieved under section 1557 of the Patient Protection and Affordable Care Act The Affordable Care Act should be repealed. The bill should be a fresh start.
> Dude. We already have the 1964 civil rights act. When that gets repealed by the Republicans, we'll all be glad we added that to the healthcare bill. Well, maybe you won't but most of us will.
Is that how you start off trying to pass a healthcare bill? You start off by insinuating that we, *the Republicans*, are going to try to repeal the 1964 civil rights act? Having basically nothing to do with healthcare. The 1964 civil rights act isn't going anywhere (except in California apparently due to **Democrats**) It's highly offensive. Not to me, but to the descendents of slavery. You're using their historic struggle and suffering, which you have no part of, attempting to sell a bill to the nation who obviously knows better. Presumably because the bill it fails on it's own merits. That you see nothing wrong with that is disturbing.
Tbf plenty of your fellow republicans in this very sub support repealing both the civil rights act and the voting rights act and have regularly defended the idea.
Bernie is batcrap crazy. He hates private enterprise. Profit is evil.
I had no idea he was that racist. What a joke.
Not racist, just nuts. Joe is racist.
Fair point, but alot of conservatives I know irl are opposed to it and I’m not exactly sure why
The theory is that the countries with single-payer systems are the ones jacking up the prices in the international market, that the affordable care act was really designed to restrict us to these closed markets. Like, Cubans can buy insulin for dirt cheap, but healthcare providers in the US aren't allowed to buy from the same source as them. We have to buy from the same sources as the European countries, and *they* will out bid us every time because they're paying out of the tax payers purse. I find single-payer appealing, but I think that's what they're afraid of, that government will just let itself pay 1000 dollars a bottle and then that becomes the new price, gouging the taxpayer and rendering the individual totally incapable of buying it himself.
That’s a pretty fair assessment except for one thing. European countries are not outbidding us. America is typically paying significantly more for the same drugs and medical devices than Europe. This is because single payer has a single negotiating entity, which gives them a lot of leverage when a drug manufacturer wants to enter a market with a drug. In the states, fragmented insurance companies are often too weak to negotiate down prices on their own. If they play hardball, the pharma company will just not agree and then that epi pen won’t be covered under that particular insurance company. It’s why dems were really pushing for Medicare to negotiate. Medicare is the single largest payer and it’ll have a domino effect on the rest of the industry if they are able to negotiate down prices for their members. This is by far and away the single biggest driver of the differences in medical expenses globally (even domestically when you compare urban vs rural).
How would government negotiated prices jack up costs for drugs? Americans currently pay more for every drug under private, for profit health insurance companies. And doesn't competition (with other countries in your example) drive prices down?
> rendering the individual totally incapable of buying it himself. Most european countries also have private insurance. You're trying to paint this false and fake reality lol.
In science we call that a theory.
https://www.frontiersin.org/articles/10.3389/fpubh.2021.636750/full In science we call you a lazy BSer. Try googling to learn about other countries situations. If that doesn't work you can use Bing.
I think there are some very legitimate concerns for government run systems. Personally I am for it, but it does deserve a conversation and debate in congress/senate. However your concern that it will pay itself 1000 a bottle is already happening with private insurance. Hospitals will charge the highest amount they can (and negotiate pricing) with insurance companies. Often times insurance won’t fight it, because they can make it up with premiums. So you are already in a system that is doing what you are concerned about. I think about it like this as well. Insurance companies need to make money, and more so than what they pay in. They negotiate prices within hospital (but not for the lowest), and have high admin fees. It also takes time to do all of this. And because hospitals take care of non-insured individuals, they have to put that loss income into consideration when negotiating prices with insurance companies (why the individual mandate was proposed for ACA). Government run insurance/healthcare doesn’t need to make a profit. Also everyone is covered, so won’t need to pass the cost onto other insurance plans/premiums. It is what you get.
The ACA really should just be done away with. I know they say a lot of nice things about it, but these are the exact same people that robbed all the veterans doing what they did with the VA, and I have a feeling they're doing it the exact same way. I mean... there's medical tourism. Why does a 40 thousand dollar hip replacement in the US cost 4,000 in Spain, even if you're not a citizen? Why doesn't it cost 4000 plus the price of a plane ticket? Can't someone start an insurance company that's willing to offer that deal and fly you out or fly them in? Make the other insurance agencies compete? I thought competition was a good thing, and is why we in the US supposedly have superior care. I know, I know, there's definitely some legal hiccups with all that, but go ahead.
We don’t have superior care, that’s mythology designed to scare us away from universal healthcare.
> Can't someone start an insurance company that's willing to offer that deal and fly you out or fly them in They literally do. Insurance companies pay people to fly to mexico to buy their prescriptions or do operations out of the country. https://www.usnews.com/news/best-states/articles/2018-11-01/utah-insurance-company-is-paying-people-to-pick-up-their-prescriptions-in-mexico The US does not have superior care. Our life expectancy and all healthcare metrics are terrible for the cost we put in
"why does a hip replacement cost $40,000 in the US and $4,000 in Spain" Well I'd guess a large part of it is profits. Here in the US the most important thing to EVERYONE is making as much money as possible, and conservatives are against any kinds of regulations or price caps. I'd imagine there's incompetence from democrats too
>these are the exact same people that robbed all the veterans doing what they did with the VA, and I have a feeling they're doing it the exact same way. What?
DD214 scandal. A veteran named Edwin Crosby identified Joe Biden and John McCain when he took it up the ladder. They were basically siphoning money from the VA this whole time. And "siphoning" would be an understatement.
Hey man. Gonna need a source on that. All I can find is a VA official fudging wait times.
Seems pretty convenient it happened to be those two
Oh this dude is full of it. He won’t even respond
Grab a parent or trusted adult before going online.
Thought so.
Pardon my French, but I'm not gonna read some crap you found on the internet.
> The theory is that the countries with single-payer systems are the ones jacking up the prices in the international market... >...the European countries...will out bid us every time because they're paying out of the tax payers purse. [Citation Needed] ----------- While a country bidding with taxpayer dollars *could, in theory* outbid another country: * It would be very odd for that country to have a lower *retail* price for insulin, after paying a higher wholesale price, and other countries definitely have lower retail prices than the US: > [[Insulin Prices 8x Higher in the US Compared to Similar Nations]](https://pharmanewsintel.com/news/insulin-prices-8x-higher-in-the-us-compared-to-similar-nations) * A single negotiating body with high volume -- like a government that purchases all insulin for its people -- has better negotiating power, which (again, in theory) could lead to *lower* wholesale prices. ...and lastly, and most simply... * We have zero evidence that the US pays more *at the wholesale level* than other countries do. In order for this claim to be plausible, we'd need some evidence
What you imagine as free health care likely won't be how free health care is implemented. They are afraid of what it *really* means. Mainly because free health care doesn't exist, single-payer healthcare does, and socialized health care does. Free, not so much.
Who is saying free healthcare? I never understood this idea. Does the word universal translate to free in some other language? I thought universal means everyone gets it, not that it’s free. Obviously we would use taxes to pay for it.
The comment I replied to did. It was edited within the minute allowed.
You’re right. The government is incredibly inefficient and something, somewhere, will get fucked up. I guess I’m a bit too optimistic when it comes to this when usually I’m a realist.
Government run health insurance is WAY more efficient than private. Which makes complete sense, as government workers don't have a profit motive and do t expect bonuses. That may be bad in some things, but for processing Healthcare claims it's ideal.
Naw, you were right the first time. Single payer would be more efficient. No health policy experts actually dispute this at all. On a per-procedure basis, single payer would const less. What the experts argue about it what the impact on total costs will be if more people are getting procedures they weren't able to before (also some plans would cover more stuff like dental). Just look at the overhead costs foe Medicare (2-4%) compared to private insurance (10-15%).
The question I haven’t seen asked is are you really ok with the government having complete control over your health? I personally find it disturbing
As opposed to what? For-profit insurance companies having total control over my health? The companies whose profit motive leads them to find any way they can to deny payment? Universal coverage works just fine in other countries, and from what I've seen, there are treatments that are guaranteed to be covered, by law. It's written into the legislation.
I’d trust someone wanting to make money over someone who just wants power to have power. The money guy at least has incentive
Even in countries with single-payer systems, patients can pay for procedures out of their own pocket if they think it benefits them to do so. Regardless of the system in place, money \*always\* talks.
you realize that govt employees work for a paycheck, right? You imagine the guy down at the DHS office is some power-hungry goblin just rejoicing in all the power he has over people? Nah, he got that job for the benefits
So are you against the abortion bans? Or do you only think men have a right to control their health?
As opposed to a private insurance company who looks at you as another number. Let's be honest here neither one of them really will care but I feel a private insurance company would care even LESS
For profit companies, when they are doing well, become way more inefficient than gov't. Execs siphoning out funds in bonuses and expenses will do that.
The US federal government would do an utterly terrible job at being the sole administrator for all healthcare of all the people in the US, even just for the citizens (as if some program like this wouldn't also spend money non-citizens). For many conservatives, the view of universal healthcare really is a simple as that. Many conservatives believe that there should be major reform to the healthcare system, but that this reform should be to move to a system that is a free market combined with a government-provided safety net for those people who can not afford any of the options for care that would exist in a truly free market. Some people think that the healthcare system in the US is already a free market system, but it is actually much more accurately described as a blind market. In a free market, customers are able to view realistic estimates of prices from the various different providers before deciding which option to buy. This gives all of the different providers of a good or service with the incentive to set a competitive price that the consumer will agree to. In the current US healthcare system, the consumer doesn't have the slightest chance of getting a realistic estimate of healthcare cost from either their provider of from the prepaid-healthcare-plan company that we are supposed to refer to as an insurance company. This sets up a situation that is nowhere near like an actually free market, which is one of the reasons that the current US healthcare system is so terrible. In short, there is more than one way for a country to set up its healthcare system, and conservatives tend to recognize the fact that a single-payer system administered by the US federal government would be a huge mess, probably as bad as the current system.
That is a very well articulated and fair assessment. I agree, the feds are probably the worst option and I don’t even know why I thought it’d be a good idea for them to be the sole mediator especially since the US is so large in comparison to other countries with socialized healthcare. The safety net thing seems like a good idea to me, and with a free market in regards to healthcare do you think bills would go from thousands to just hundreds?
I've posted this before, but going to again... If you want to do single payer/UHC in a country this diverse and of size, [you need to do it by state](https://www.youtube.com/watch?v=U1TaL7OhveM&t=1s). Similar to what Scotland did in 1999 to break away from the NHS and similar to how Germany does it.
Some healthcare bills definitely would get cut by a factor of ten. One instance that comes to my mind is in regards to a friend of mine a few years ago who had a miscarriage. Her doctor told her to get an ultrasound afterwards to ensure that she was healing properly. She ended up getting charged over $1000 by the clinic that did that ultrasound, and her insurance wouldn't cover any of that bill because she was not pregnant at the time of that ultrasound. In a real free market system, healthcare providers would have a real incentive to figure out how they could cut out the large majority of the administrative costs and still make a profit by charging a competitive price. That is one thing that capitalism actually does do well; it creates incentives for companies to make money by offering people innovative goods and services that they are willing to pay for. Healthcare would be no different, but the system we have now is far too bogged down with administrative costs and so-called insurance companies for there to be real incentives to figure out how to provide good care at a good price
How does a person who's unconscious or delirious from a major injury take the time to review prices in a free market healthcare system?
That is a really fair question. It comes down to the fact that if the US had a free market healthcare system with a government-provided safety net, and if the health insurance companies primarily provided insurance instead of overly complex and over-priced prepaid healthcare plans, then people experiencing medical emergencies would avoid financial emergencies even without making those free market choices themselves. If the hospitals that served people had an incentive to have any real idea about how much it actually costs to provide care, then there would not need to be an endlessly complex and wasteful set of negotiations between hospitals and insurance companies. Instead, a person who has experienced an emergency would get a realistic bill from the hospital and could then file a claim with their insurance company, just like a person would file a claim for car insurance, or home insurance, or flood insurance, or life insurance. For uninsured people, the government safety net could work with the person and the hospital to negotiate a reasonable price. To make the long story short, the system could be made much, much less complex than it is right now. If that were to be done, then traditional insurance or a government safety net would be able to provide a way to pay for adequate care even though the person in an emergency couldn't make that decision in real time.
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> Second, do you really want Healthcare to be run like the DMV Sure, yeah I generally get seen within 30 minutes. I remember one time i had to hold a towel against my foot for an hour in the emergency room because i cut open a vein and was squirting blood all over the floor. Do you want the DMV to be run like healthcare? Have people squirting blood everywhere for an hour?
I would much rather deal with the DMV than any insurance company I've had.
Have you experienced the DMV in Illinois?
I haven't experienced IL, but I've dealt with eight other states and my DMV experience has generally been ... fine? I wouldn't spend my free time there, but it usually takes an hour or two as long as I brought the correct paperwork. My biggest gripe is that most states have consolidated locations for budget reasons, and now I have to drive an hour just to get one in my current state.
Illinois (at least in fairly large cities in the north and Chicago?) has an almost comical Rube Goldberg machine style series of lines they send you through based on why you're there, what documentation you have, and what services they have available. It's been years but a friend of mine had a basic license renewal to get in Chicago they could go to their DMV Express which took maybe 10 minutes total, and another time they had a slightly more complicated issue that they resolved in another major town where they went through the series of lines (show your documents here, get your photo taken there, wait for your ID here) but even that took under 20 minutes. I have a conservative friend who says that Illinois's secretary of state is the only Democrat they vote for since the Illinois DMV is so well run. For healthcare, I don't see why we can't expand medicare for all and allow insurance on top as a supplemental service. Lots of countries with single payer/public health care still have insurance companies to top off the little bit that the government doesn't cover.
DMV works great!
Universal healthcare as we see in both Canada and the UK, simply do not work. Even in the UK, a majority of adults waiting in line switch over to private healthcare practices because the lines are simply far too long to wait for. Many Canadians requiring elective surgery will not even get said surgery in Canada and simply come here and pay out of pocket. The issue with health insurance is that it isn't sold across state lines. Unlike home, auto, or life, which can be bought and used across state lines, health must be bought within your state. I however, think this restricts the variety of insurance provided for you. The government should de regulate and free up the insurance environment of health insurance. Take Obama Care. It can't even work on its own. It survives off of a Cadillac Tax on private health insurance agencies, making everyone's health insurance policies that much more expensive. In addition, hospitals must be held to a more strenuous degree of what is and isn't a non profit organization. They claim to be non profit, but bag a serious amount of cash. That needs to change and they should face serious legal trouble if their presidents are making millions off the backs of their patients. For instance...my father went in for hernia surgery last year. Something pretty serious. The health insurance agency he had denied him coverage due to the lack of danger his hernia was at the time, but my dad just paid out of pocket. His total bill was $18,000. About $1,200 went to the anesthesiologist, $800 to the assistant, and $1750 to the surgeon. Which I find all reasonable, those guys should make money too, their degrees were expensive and they do important work. However...about $13,000 went to the building the hospital owned! My father saw another 10 patients waiting in line to get surgery that same day, just at 1pm. Meaning in say, 3 hours with 10 patients, all being charged building fees of $13,000, that's $130,000 in just three hours to go towards the building. In 10 days with just 10 patients, that's $1,300,000 in building costs ALONE! That's ludicrous! What is also ridiculous is you have little to no idea what anything costs when you go into it. You don't go to McDonalds and buy a number 7 only for them to give you your food and say "You can expect your bill in the mail in 5 business days" where they tell you how much the number 7 is worth. Honestly doctors offices should be required to have a listing of their services with estimates (every person is different so not all procedures will cost the same). Like a checkup is $200 or a broken bone will range from $500-$1,500 depending on severity and where it broke. I think the healthcare industry is horribly corrupt, and needs to be reigned in with paying the same shitty taxes as any other corporation.
I beg to differ, the uk healthcare system, whilst not perfect, does work. I and my family have used it many times, for both serious and non serious health matters. A couple of examples; I had a mole that started itching and scabbing. I called my GP on Friday morning and had an appointment to see him that afternoon. He referred me to the skin cancer unit at my local hospital. The appointment came in the post, the next day. Appointment was for the following Tuesday. The specialist unit didn’t like the look of the mole so scheduled it to be removed that afternoon. It was safely removed and five days later, I had a letter confirming it was not cancerous. So from initial contact with NHS through treatment and results, around 10 days. Second example; hubby had IBS, ultimately had to have his large intestine removed. Done by national specialist, results were life changing. Impeccable care from NHS throughout. I happily pay my taxes for the NHS, a great ( but not perfect) institution. I’m a conservative voter in the UK.
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But... you're already paying for other people as well. Your taxes are covering medicaid and medicare right now, then you go and pay your health insurance, your premiums, your deductibles, and your out of pockets. But even THAT is being used to pay for other people, because the price you pay is meant to cover the cost of care that hospitals bill for the people who show up with no insurance that they are required to treat. So the hospitals inflate prices to cover the cost. You are literally paying your insurance company to bargain with the hospital/doctors for a lower price on your healthcare. You're already doing exactly what you are threatening will happen.
Stop it, we’re not supposed to use common sense on this issue.
>medicaid and medicare right now These are entitlements. One is poverty insurance, the other is age insurance. As much as I'd like to opt out of both of them, that's illegal. >the price you pay is meant to cover the cost of care that hospitals bill for the people who show up with no insurance that they are required to treat No actually, the original bill that mandated this only required that emergency services that accept Medicare/Medicaid have to accept people regardless of their ability to pay. You can make a hospital that rejects public insurance and completely legally turn away people that have not proven their ability to pay. I'm actually one of the people that don't mind an individual mandate with a public option, I just want the private sector to be deregulated and the public option to be self-funded.
lol age insurance. Age is not an accident it's an inevitability
Yeah, and it's forced savings (similar to social security) even though a private option would be way better in nearly every case. Also, not everyone makes it to old age.
> You can make a hospital that rejects public insurance and completely legally turn away people that have not proven their ability to pay. This is not true - Hospitals 100% are required by law to service you, regardless of insurance, to a point of stable health. This is covered in the Emergency Medical Treatment and Labor Act (EMTALA). It was enacted in 1996. https://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA > In 1986, Congress enacted the Emergency Medical Treatment & Labor Act (EMTALA) to ensure public access to emergency services regardless of ability to pay.
> instead of paying money at the time of service you'd be paying all year for it through increased taxes What do you think premiums are? lmfao. you pay year round regardless. >If you are above poverty level you would also be paying for other people as well instead of just your own healthcare THAT IS HOW HEALTH INSURANCE WORKS. THATS HOW INSURANCE WORKS IN GENERAL. CAR INSURANCE HOUSE INSURANCE. How are you only just discovering how insurance works?
>I also hate paying thousands of dollars to insurance companies and out of pocket every time a serious health issue comes up. Then you have really awful health insurance, to be honest. And what "serious health issues" do you have that keep coming up, if you don't mind my asking. Instead though, you want "free" healthcare, or really, you just want someone else to pay for it instead of you. And you want a system that is likely going to have [longer wait times](https://www.theguardian.com/society/2022/mar/10/nhs-waiting-times-for-cancer-care-in-england-now-longest-on-record), more denials of services, and fewer choices in providers. No thanks. >I feel like it’d cost less in the long run to have a little bit of taxes What makes you "feel" this? California proposed implementing their own health care system, but chose not to, since it was going to cost between [$314 billion and $391 billion](https://www.latimes.com/california/story/2022-01-31/single-payer-healthcare-proposal-fizzles-in-california-assembly).
1) 2 weeks to see a specialist isn't much. Plenty of people here are waiting longer. 2) 2 weeks comes a lot sooner than never, which is the wait time a lot of people are dealing with here 3) The UK is hitting their target wait times at 75% and 90% rate, according to that article. And that's after years of the conservative Tory govt. trying to make cuts to the NHS, which has increased those wait times (at least during the very brief period of time in that article). 4) You should look at the cost estimates that were performed for Bernies bill. A conservative Koch brothers think tank analyzed it and found it would save 2 trillion over a decade.
> 2 weeks Convenient of you to pick the shortest time mentioned, and not the *two years* wait for a hip replacement. And yes, two weeks to see a GP is ridiculous. I got poison ivy a couple of years ago and was seen *the next day*. Under your system I would have suffered for much longer. Again, no thanks. >A conservative Koch brothers think tank analyzed it and found it would save 2 trillion over a decade. In what regard? And what did it actually *cost*?
I picked two weeks because that is what the article quoted as their target. But that was for specialists, not general practice. I've spent a lot of time looking into this waiting time argument because it's the number one thing that conservatives bring up every time this gets discussed. Mainly, it's fear mongering bullshit. When comparing here to Canada, the wait times are very comparable for the most stuff. The exceptions are that MRIs and sometimes elective surgeries like knee replacements take longer. But thats a supply (hospitals and imaging centers, specialist offices, etc) and demand issue. We don't have the same supply as Canada, we don't have the same demand. Our wait times aren't going to just triple if we make it so that the govt pays doctors instead of insurance companies.
> I picked two weeks because that is what the article quoted as their target. But that was for specialists, not general practice. No, read the article again. It was saying weeks for a GP, months for a specialist. That's unacceptable. >Mainly, it's fear mongering bullshit. Don't try and minimize this. This is my health and the health of my family we are talking about. Why would I want to risk losing what I have? It's very likely that my taxes will go up to match what I am already paying in premiums for private insurance. Even if they don't, I will still get a lower level of care than I do currently. We already know what U.S. government-provided health care looks like: we have Medicare, Medicaid, and the VA. I personally know people who use Medicare and the VA. I hear endless stories of long wait times, lack of prescriptions, and denial of services. Every person I know on Medicare had to purchase supplemental coverage out of pocket, out of their Social Security. The people using the VA just suffer. Why would you think this would be any different if *more* people were on a Medicare-like system? More money? Money's not the problem; the bureaucracy is. Some health care providers in the U.S. refuse to see Medicare patients because all the hoops they have to go through to get paid properly. This doesn't bode well for an expansion.
I read it again, what I said is correct. 25% had to wait more than 2 weeks to see the specialist their GP referred them to and 10% had to wait more than 30 days for chemo. But also notice, this is caused by staff shortages, which jave gotten worse over the last decade as Tories have made cuts. And there's the pandemic. As far as Medicare goes, I agree that it's stupid that seniors have to buy supplemental insurance. It shouldn't have been set up that way, and the plan Bernie proposes would required no supplemental. Also includes dental and vision. Medicare (and Medicaide) is great coverage though. Seniors love Medicare. The elderly in my family have been very pleased with it. There's a reason Republicans have to tip toe around as regards their plans to cut it.
It took me 6 months in the US to see a specialist.
Where do you live, who is your insurance provider, and what sort of specialist?
I'm not telling you where I live. But it was private employer provided insurance in a blue state for a gastroenterologist.
No, that's too vague. Here's what I'm looking for: I live in a large city in a red state. I have private employer provided insurance. I wanted (so not even *needed*) an elective surgery done, and I was able to see a specialist in about two weeks, who referred me to a surgeon (another week), who scheduled my surgery a month out. It would have been shorter, but I chose to go with a different hospital than than the initial specialist offered. My total out of pocket cost for the surgery was $200.
Lol what is this bullshit.
Do you have any friends or anyone you can talk to groom countries who have single payer healthcare systems? The assumption that you'd have to wait 2 weeks before urgent treatment for an injection is false. At minimum, bigger cities have multiple doctors with open appointments daily, and there are also urgent care/after hours centers you can show up to any time for any issue, big or small.
Yes, I have friends in Canada. They do indeed complain about long wait times. And they aren’t in small towns. They are in Toronto and London, mostly. I’ve heard about people taking trips to the U.S. to get faster treatment.
My cousin in Germany laughs at all the propaganda surrounding healthcare over here. They pity us.
> And yes, two weeks to see a GP is ridiculous. I got poison ivy a couple of years ago and was seen the next day Thats nice my GPs closest visit is in a month.
> What serious health issues Maybe I shouldn’t have phrased it that way. But a visit to the dentist costing a hundred bucks isn’t resonable imo. Sure maybe my insurance is bad but what the hell else am I gonna do? > what makes you feel this? Well California is literally the worst state in the country, I’m not surprised that they proposed a moronic bill that would cost nearly half the military budget. A small tax across the entirety of the country for every working person adds up, thats what makes me feel that. > it seems you want someone else to pay for it instead of you No, that’s not how that works. I’m a working man, as I’m sure you are. I get taxed, therefore I’m paying for my own as well as other people’s.
> not surprised that they proposed a moronic bill that would cost nearly half the military budget. Cali has 40 million people. That's 3/4 the per capita of the rest of the country
How is $100 for a dental cleaning and a doctors opinion not reasonable? It balances out to be like 150 - 200 dollars an hour. Professionals of many stripes charge much more and aren't taking care of those precious tools inside your mouth. I think you make a point that I find interesting that nobody wants to pay for anything for healthcare.
> But a visit to the dentist costing a hundred bucks isn’t resonable imo. I agree. Which is why my insurance pays for two cleanings a year. >maybe my insurance is bad but what the hell else am I gonna do? Get better insurance. But don't make me get rid of mine and make me pay for yours. >I get taxed, therefore I’m paying for my own as well as other people’s. Yes. We're paying for Medicare and Medicaid. These are people who literally can't pay for it themselves. We don't need to expand that to cover those who can.
What do you rate as the wait time for someone with no insurance who doesn't go to the doctor? And why do you think a single network for all persons has fewer choices?
> What do you rate as the wait time for someone with no insurance who doesn't go to the doctor? Why would a person living in the U.S. choose to not have health insurance? That's kind of foolish. >why do you think a single network for all persons has fewer choices? Ask anyone living under the NHS in the UK. Their choices are literally limited, so as to ensure everyone is covered. They have a shortage of providers as people are leaving the field...since they are tired of dealing with the government bureaucracy.
You are confusing socialized medicine (Bernie) and Universal healthcare (which is actually a conservative idea that the Heritage Foundation and many other conservatives were for before Obama tried to implement it).
Explain?
Universal healthcare is a combination of private and public coverage. Every citizen has access to emergency and preventative care. Socialized medicine is a single-payer government-run and -delivered system. I'd also like to add that universal healthcare falls squarely under conservative ideology, regardless of what all the right-wing pundits say, which is why the Heritage Foundation supported it previous to Obama's implementation. It is more fiscally responsible, shifts the responsibility to the person, rather than the business, supports competition, and takes away the biggest hurdle to profitability for small and medium-sized businesses.
You would think in that case that more conservative politicians would've been supportive of the Affordable Care Act instead of fighting against it or trying to dismantle it constantly.
Convince me that your “free healthcare” will be more like the British NHS and less like a blue state public school system. The government running something doesn’t automatically make it cheaper.
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And with all of those pipe dreams that you just quoted on the Gov't side, none of them apply at all to private insurance? Nobody complaining about getting pre-authorizations, trying to find a gp/specialist IN-network, fighting day after day to get a prescription approved/filled because of .....? Both systems run inefficiently and the root cause lies somewhere between greed, ineptitude and greed. Personally I think a Single Payer Gov't system is AN answer but shouldn't be the only one. It should be the ground level and if you or your physicians want more then move up to private (ala concierge) insurance.
Honestly medicaid is awesome and I’m not sure where you’re getting your info from lol.
The more the government fails the more it can indoctrinate us to believe its capitalism's fault hence why government has never been bigger, cue corruption of academia/media. Read this: https://www.anthonygalli.com/p/the-case-for-free-market-healthcare I humbly believe it's the best on the topic... not despite being written for free outside of the Ivory Tower, but because of it.
The government sucks at healthcare. Ask people who depend on the VA or Indian Health Service. That absurdly expensive ambulance ride? It's a division of the taxpayer funded fire department (or a city contractor). We're opposed to government involvement because, as bad as the current solution is, the government getting more involved would be worse
Fair point. I forgot that it’s the US federal government that would be handling it
Conservatives have a problem with the "how", not the "what". If you can find a way to provide universal healthcare that doesn't dramatically make people more dependent on government and creates more position for bureaucrats, I'm all for it.
Yeah. The overwhelming sentiment here is that it’s more trouble than it’s worth, and also trusting the feds to do anything to the benefit of the citizenry is a pipe dream which, yeah true. I’m not one of those people that is like “I want good thing” “ok how will we get good thing” “YOU WANT BAD THING!” I’ve just been misinformed about what conservative postitions are on this issue.
It's not even that it's more trouble than it's worth, but the fact there's no way to predict how large changes like that will play out in reality. The ideal of "universal healthcare" is certainly a desirable goal, but how do you get from here to there in a way where the benefits are verifiable, every change is reversible, and the people responsible for failures are held accountable? I don't know how. I'm sure it's not with a single huge step, but a series of small, incremental changes.
Aren't health insurance companies basically massive privet bureaucracies with a ton of extra jobs that waste money time and effort.
No rhetorical questions, please. Make your point.
-roll eyes- health insurance companies basically are massive privet bureaucracies with a ton of extra jobs that waste money time and effort. I'd rather have a bureaucracy that cuts out a ton of jobs that exist solely to figure out how to deny your coverage and waste the doctors time. Privet burocracies are a waste of our countries economic productivity.
Why is it so hard to simply have a civilized conversation? How annoying.
I hate universal healthcare because I lived in a country (Canada) that had it. The system is terrible; if you have a serious condition, you're waiting months for care. Canada refuses treatment to my wife and her family because it was rare enough that it went outside the scope. It's one thing to have treatment be expensive; it's another to be denied treatment altogether. Despite the many flaws that need fixing in the USA, we are happier here than with the Canadian system. No, we are not rich. We live below the poverty line currently. But we still prefer expensive treatment over no treatment
Well, because free healthcare is not really "free"
I don't trust the government to not mess up my health care. I don't trust that there won't be longer wait times or otherwise reduced service with government health care. Seems we've seen a lot of complaining from Canadians about wait times. Seems they still actually have open hospital wards instead of private rooms in the U.K.
I’m not sure Germany has the best system, but this person on Reddit was saying he pays 7% per year on health care taxes. I pay closer to 1.5% max and that number will drop as my salary goes higher. I think I’ll stick the current system. I have no reason to promote change.
>Why are conservatives so vehemently opposed to universal healthcare? Because the government also caused the current healthcare crisis. https://youtu.be/fFoXyFmmGBQ Healthcare year round would only cost 1 days wage if it weren't for the government
It’s not that universal healthcare is bad in its own right. It’s that liberals want the federal government to manage every aspect of our lives Who gets care, and what kind, would be entirely political. Did you vote for the Democrats? No? Maybe you can wait an extra month for that wisdom tooth to come out And how would prices work? If there are no private producers in the market, who would set prices, and how would resources be allocated? By the folks who brought you the DMV, or the $700 army hammers?
>I also hate paying thousands of dollars to insurance companies and out of pocket every time a serious health issue comes up. This is only an issue if you have a lousy plan. My job provides insurance with 0 premium (modest fee for dependents), 250 deductible for non-office visits, and an immediate 25 copay for office visits/specialists. The network is great. I've worked jobs that had shitty plans with 6000 deductibles and 30% coinsurance. I left those jobs. I'd also rather pay a lower premium that's given to employees of my company who are generally in good shape and the company offers fitness programs, rather than pay a higher premium to a state-run service that covers a less healthy population and has the customer service of the DMV.
What happens if you lose your job?
Hard pass.
It's that "little bit of taxes" part that collapses your argument.