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LoneSnark
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I think people are misunderstanding what is meant by the term "cap" in my post. It isn't an age cap. It is a lifetime expenditure cap. It is just as plausible for a young chronically sick patient to exceed the $1.2 million cap as an old person can die of old age without ever approaching it.

Of course, they are free to spend their own money after the government's money as run out.

11/3/2016 3:51:16 PM

Big4Country
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Why not get treated in Canada since their health system is so much better?

http://abc11.com/entertainment/michael-buble-announces-3-year-old-son-diagnosed-with-cancer/1589429/

11/4/2016 3:51:59 PM

stowaway
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no one said you can't get great care if you have the money, but for an average person with non life-threatening illness or injury then the single payer system is usually much better.

11/4/2016 4:15:59 PM

goalielax
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^^god damn your an ignorant callous piece of shit

11/4/2016 4:23:34 PM

OopsPowSrprs
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^^^ please apply your clown makeup with a shotgun next time

11/4/2016 4:37:52 PM

adultswim
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breaking

lower middle class man passionately argues against healthcare policy that would benefit him personally

11/4/2016 6:20:44 PM

AntecK7
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you are ignoring the fact that he may aspire to no longer be "lower middle class". People may vote from the perspective of where they want to be, not where they are now. Logically it may make sense for me to rent a 1 bedroom apt, because I don't currently need more than that. But I may invest in a house because long term I imagine having a wife and kids.

Healthcare is always a finite resource, just like anything else. How you see it should be distributed is likely a result of where you are now, and where you want to be.

There are a lot of people who are pro single payer, who would still buy their own heath care. the 1% and the lower 49% are all on board with it. However, the other 50% realize that their standard of healthcare, or healthcare costs could actually go higher, because they are smart enough to realize its a zero sum game.

the 1% don't care that their costs have gone up, and the other 49% are happy for the benefit.

11/6/2016 11:35:34 PM

Dentaldamn
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That is a word salad

11/7/2016 6:50:31 AM

AndyMac
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^^ You say it's zero sum but only include one side of the equation, the recipients, without considering how a single player system would affect medical providers. Like insurance companies and big pharma.

11/7/2016 7:16:26 AM

rjrumfel
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So that is another question I have that I didn't ask earlier.

Insurance companies are so baked into our economy now. What happens to them if we have some type of UHC? Do they just lock up and call it a day? What about all those that would become unemployed if that were to happen? I would assume the government would absorb some, since they would need the knowledge base, but

What would the layout of the healthcare insurance industry look like after implementation of UHC?

11/7/2016 1:24:32 PM

OopsPowSrprs
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They become government contractors

11/7/2016 1:27:57 PM

LoneSnark
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Depends how you did universal healthcare. They are already government sponsored enterprises. You can just make that official and we would then have Universal Healthcare...that everyone either cannot afford or simply refuses to buy.

Throwing a bunch of college educated actuaries out of work is not a concern I entertain. But, at least some of their effort went towards containing costs by refusing to pay for some things. That behavior is needed, although it would be better if it were the care providers themselves that had the incentive and authority to ration care.

Singapore has an interesting solution. There, the government forces everyone by law to save for future healthcare costs, but allows them to be pooled among the family. People sign up too pool their accounts because it allows the children to inherit the health-savings of the prior generation, and 2, if an aging parent exhausts their health-savings, relatives who have not can cover it. As such, many families pool their forced savings accounts among the whole family. This is a major cost limiting feature, because it forces people to act as if they are spending their own money whenever they seek healthcare. As a result, Singapore has almost the lowest healthcare costs as a share of GDP among the industrialized world (around 10% of GDP). There is insurance, I don't know that part of it, but my understanding is they're not allowed to spend their health-savings accounts on insurance premiums, which is a feature I really like.

In that system, many old people upon getting sick often self refuse care for fear of draining the family's health-savings accounts.

The price system is the best method known to man to ration care. If you're spending your own money, you will shop around when possible, and your doctor will themselves often recommend dramatically different treatments when they know the patient is paying. Because nearly all patients and their families are price conscious, drugs and treatments are often available at a fraction of the cost in the U.S.. The down-side, of course, is humans often don't save, and the price system doesn't work for people that don't have any money.

So, another good government run system is this: The government regulates and maintains health-savings accounts for all citizens. It starts them out with a modest amount, say $10k per baby, which families are free to pool as much as they want. This is coupled with a forced savings rate, say 10% of income. By pooling, families can inherit. On top of this, the government provides catastrophic insurance which has ruinously high lifetime deductibles, say $60k, with very low lifetime expenditure caps, say $800k. Not being a poor country, 10% of income compounding every year is a significant sum. Combined with the cheapest care the price system can manage, the vast majority of the population for most of their lives will never exceed their health savings accounts. If you get cancer at a young age, family and relatives will donate their own health-savings funds to cover your treatment or at the very least, reach the deductibles needed for the government insurance to start paying.

Any thoughts and/or questions?

11/7/2016 2:48:09 PM

rjrumfel
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But how does the price system work with disastrous diseases like cancer. Even though drugs are cheaper, I couldn't imagine most chemotherapy drugs to be cheap enough to afford out of a pooled HSA.

11/7/2016 2:53:51 PM

LoneSnark
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Quote :
"If you get cancer at a young age, family and relatives will donate their own health-savings funds to cover your treatment or at the very least, reach the deductibles needed for the government insurance to start paying. "

11/7/2016 5:42:04 PM

Big4Country
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Quote :
"breaking

lower middle class man passionately argues against healthcare policy that would benefit him personally"


The last thing I want is more government involvement in my life. In the past I have had my own insurance that wasn't through work and the cost wasn't bad. It was a good plan too. You can't get that anymore and I don't want the government taking more of my money. I would rather have the option of signing up for employee insurance, or finding my own.

11/7/2016 8:10:07 PM

adultswim
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This is pretty awesome, especially the Republican numbers.

https://www.kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-march-2018-prescription-drug-pricing-medicare-for-all-proposals/



[Edited on March 28, 2018 at 2:51 PM. Reason : .]

3/28/2018 2:47:41 PM

UJustWait84
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.

[Edited on March 30, 2018 at 8:47 PM. Reason : .]

3/30/2018 8:47:23 PM

Big4Country
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^^Not really. Universal healthcare isn't as great as people make it out to be. From what I hear it works great if you need to go to the ER to get a cast put on and then go home, but you better hope you don't catch cancer, or have any major medical problem. In England recently people took to the streets to protest the conservative wing of the government holding out funding for the national health service. You don't think our 2 major parties won't play politics if we go universal? I heard a libertarian on the radio about a year ago explain how Trumpcare was worse than Obamacare (he liked neither). He said when Obamacare started a high risk pool was temporarily setup for high risk people who couldn't get insurance. He said roughly 115,000 people signed up because people who wanted insurance already had it through the VA, Medicare, Medicaid, work, or individual plans. The private plan with a government option like you posted above sucks because you end up paying twice if you go with a private plan.

3/31/2018 10:10:05 AM

dtownral
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Our resident expert

3/31/2018 1:26:17 PM

Cabbage
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Quote :
" In England recently people took to the streets to protest the conservative wing of the government holding out funding for the national health service. You don't think our 2 major parties won't play politics if we go universal?"


Are you suggesting we should avoid it simply because politics can be played with it? Well OK then, bye bye 2nd Amendment.

3/31/2018 6:56:44 PM

LoneSnark
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We don't have single payer fire-arms. The gun stores stay open in the event the government shuts down.

3/31/2018 11:50:42 PM

synapse
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Quote :
"From

what

I

hear"

4/1/2018 1:06:56 AM

beatsunc
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there are millions of people that cant afford food. we need single payer groceries

4/1/2018 6:49:37 AM

Dentaldamn
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https://farm.ewg.org

4/1/2018 7:27:30 AM

beatsunc
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^bull crap too. stealing money out of poor peoples pay check to give to billion $ corporations

4/1/2018 8:16:55 AM

Big4Country
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Quote :
"We don't have single payer fire-arms. The gun stores stay open in the event the government shuts down."


Exactly! With government health we will eventually get rationing.

4/1/2018 9:51:39 PM

skokiaan
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I just used my private health insurance to book a specialist 2 months from now.

We have rationing now

4/2/2018 11:28:10 AM

dtownral
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yeah, but from what i hear we'll have death panels

4/2/2018 12:52:10 PM

Cabbage
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^Yeah, if socialized health care ever gets implemented, we'll be longing for the previous days when no one ever died from health complications.

That only happens when gubmint is involved.

4/2/2018 4:08:41 PM

AVON
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The older I get, the more and more I'm for a universal health care type system. My wife is from the Basque Country in Spain, and our son was born in a public hospital there. Somethings are different that folks here wouldn't like such as you might share a room for example, but overall it is drastically better.

- Service in both the hospital and doctor's visit (pediatrician) were fantastic compared to here. You make an appointment, go in etc... they are no worse than here being on time, don't have to fill out 5 forms at each visit, instead of 4 secretaries per 1 doctor, there are 6 doctors per secretary. When we had our son, they kept here in the hospital for around 3 days just to help take care of her. Friends here are driven out of the hospital in a few hours to save money.
- Nurses are really attentive -- they came by at least once per hour to check
- Average stress level for a citizen is lowered. Folks are to be more professionally mobile as you don't have to worry about losing healthcare going from place to place
- Doctors spend more time talking to the patient. We chatted with the doctor for ~20-30 minutes at each checkup. Doctor here has us out in like 15 minutes...

Yeah they might not treat some of the crazy cancers as well when you are 80 years old, but we as a society shouldn't be spending the bulk of our health care $$$ trying to extend the life of someone that age.

Doctors won't make as much, but they will do alright
Insurance won't make as much, but it's not an ethical business anyway IMHO
Thousands of people will be out of work who process insurance claims, process billing, etc... but this doesn't add any value to anything, It's just waste. Eliminate the need, lower the cost, and focus on providing services, not charging for them.

4/7/2018 4:54:06 PM

rjrumfel
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^The people that would be out of work...many of them could actually transition to working for government offices that would administer the healthcare.

4/7/2018 5:46:38 PM

ScubaSteve
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Quote :
"Thousands of people will be out of work who process insurance claims, process billing, etc... but this doesn't add any value to anything, It's just waste. Eliminate the need, lower the cost, and focus on providing services, not charging for them."


I agree with this statement and always wonder why this isn't brought up more often in the single payer discussion. I once read a couple post here from a guy who was in one of those jobs and he knew what a waste it was. I guess it's easier to continue to point to one CEO making millions rather than 10s of thousands of people make middle incomes.

4/7/2018 9:01:15 PM

beatsunc
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"Sen. Bernie Sanders' "Medicare for all" plan would increase government health care spending by $32.6 trillion over 10 years, according to a study by the Mercatus Center at George Mason University in Virginia."



7/30/2018 7:04:37 PM

A Tanzarian
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From the same report:

Quote :
"national personal healthcare costs decrease by less than 2 percent, while total health expenditures decrease by only 4 percent"


The same paragraph goes on to lament that single-payer cost savings would be squandered on more generous benefits for more people using their healthcare more often.

7/30/2018 7:37:32 PM

dtownral
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^^ that's less than without single payer and everyone has healthcare

7/30/2018 8:44:40 PM

rwoody
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Lmao of course beatsunc would parrot a bullshit headline

7/30/2018 9:01:33 PM

Cherokee
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https://theintercept.com/2018/07/30/medicare-for-all-cost-health-care-wages/

Quote :
"But what the Associated Press headline fails to announce is a much more sanguine update: The report, by Senior Research Strategist Charles Blahous, found that under Sanders’s plan, overall health costs would go down, and wages would go up.

The study, which came out of the Koch-funded research center, was initially provided to the AP with a cost estimate that exceeded previous ones by an incredible $3 trillion — a massive error that was found and corrected by Sanders’s staff when approached by AP for comment.

But despite that correction, the report actually yields a wealth of good news for advocates of Sanders’s plan — a remarkable conclusion, given that Blahous is a former Bush administration economist working at a prominent conservative think tank."


[Edited on July 30, 2018 at 9:46 PM. Reason : a]

7/30/2018 9:45:56 PM

rjrumfel
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I read through this article https://www.washingtonpost.com/graphics/2017/national/single-payer-explainer/?utm_term=.45b64f8b1279 hoping that it would explain a little more regarding exactly how something similar to single-payer would work in this country, and I feel like I need more details before I could even begin to consider getting behind something like it.

For example, my employer currently pays approx. 14k per year toward my health care premiums. This is of course tax-deductible for them, and my remaining portion (approx. 450/month) is taken below the line, so I'm not paying income tax on it. Say we switch to something resembling single-payer. My company no longer has to pay for my insurance as a benefit, but perhaps they'll still offer supplemental insurances, as it sounds like for those in the middle to upper income brackets, we'll still need something to cover gaps, but it still wouldn't come close to that 14k per year. So in theory, I should get that money back in my pocket.

I also wouldn't be paying 450/month for my portion of the premium, but rather a smaller portion of that for some supplemental plan.

So say I get 10k back from my employer and I get 3k back from the premiums I pay. I'll be taxed for an extra 13k worth of income. I'll definitely be paying more in taxes.

But the unknown variable here is how much more our taxes would need to go up to cover that 32 trillion mentioned in the WaPo link above. That is what scares me. And of course there are the stories of other big bad governments not approving certain procedures.

That doesn't necessarily bother me all that much, as private insurers deny coverage for certain procedures all the time. I guess it just sounds much worse when you put the onus on the government rather than a private company.

Another issue is the scale of our economy vs all of the other countries mentioned in the WaPo article that currently implement something that almost resembles single-payer. The largest of those being Japan, which is almost 1/3 of the population of the United States. Would scale matter? I don't know. The US would certainly have to provide healthcare to more people. Now, the poverty rate in Japan is about 3 percentage points higher, so if you look at it that way, Japan may have to invest more in its healthcare system per person than the US would. It's just that the US would have more persons.

I don't know. I could possibly be swayed toward single payer if someone could tell me exactly how it will affect my pocket book. And I'm not even looking to save money. I'd be ok breaking even with what I'm paying now for the same type of services, with an expected small uptick in costs year over year to keep up with inflation. It's just losing a huge chunk of a work benefit that is a little worrisome. Because we all know that employers are just going to pocket the money from not having to pay for insurance. I was being optimistic before when I assumed that my employer would give me 10 of the 14k back to me.

7/30/2018 10:22:42 PM

A Tanzarian
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Quote :
"But the unknown variable here is how much more our taxes would need to go up to cover that 32 trillion mentioned in the WaPo link above"


It's not unknown: total health care expenses will be several percent less with single-payer than without. Whatever extra you pay in health care taxes will be less than what you and your employer are currently paying.

Quote :
"Because we all know that employers are just going to pocket the money from not having to pay for insurance. I was being optimistic before when I assumed that my employer would give me 10 of the 14k back to me."


What are your thoughts on unions?

7/30/2018 11:19:31 PM

rjrumfel
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I work in IT. As soon as we start to unionize companies will start outsourcing again.

7/31/2018 8:27:59 AM

titans78
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^^ not knowing how it would all work and I get the gov’t easily mess things up I feel any system that cares more about health is better than a system that puts profits ahead of health. I also would have to believe in the long run a system that gets all people access to preventative care/early diagnosis is better than people with little to no insurance getting to a point where treatment cost way more when a yearly physical could have helped sooner.

7/31/2018 8:34:06 AM

A Tanzarian
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^^

Your concern with single payer is that it will cost you money. Not because the health care itself is more expensive, but rather because employers will take advantage of the situation to reduce total compensation. Furthermore, you're afraid employee resistance to reduced compensation will result in lost jobs.

Is that right?

7/31/2018 1:44:08 PM

rjrumfel
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Who wouldn't be concerned about cost? I'm concerned about my insurance costs going up every year as it is. As least now, the rise in costs is somewhat predictable.

To take the whole system and delete it and start fresh with single payer, not knowing how it will affect us middle class folks is scary to me.

So yes, I'm concerned about costs. How will it affect my family? Will I break even since presumably I will have a higher income and minimal insurance premiums while paying a lot more in taxes? Or will my salary stay static, and I just won't be paying for premiums, but essentially making that premium payment in the form of higher taxes?

7/31/2018 2:15:19 PM

A Tanzarian
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I'm painting this conversation with my perception of your political views, but:

I'm trying to reconcile your right-wing dislike of government with the fact that your single-payer cost concerns seem to revolve around the power your employer has and whether or not your employer will use that power to take single-payer cost savings (and then some) for themselves at your expense.

7/31/2018 3:15:25 PM

adultswim
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so rjrumfel, you recognize that single payer, a socialist policy, is a good idea, apart from the fact that rich people will try to fuck it up at our expense

come on man, the only thing separating you from socialists is the fact that you're scared of the rich and they aren't.

7/31/2018 3:44:04 PM

JesusHChrist
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[Edited on July 31, 2018 at 7:15 PM. Reason : ]

7/31/2018 7:14:44 PM

Dentaldamn
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Well that is just sad.

7/31/2018 9:23:29 PM

rjrumfel
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What is sad? The fact that I would consider single-payer once someone explained how it would affect me?

8/1/2018 8:26:18 AM

adultswim
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It's sad that you're afraid of single payer solely because you believe employers will pocket the savings. Do you want to keep living in a world where the rich have you by the balls? Or do you want to hold them accountable and make the world better for your kids?

https://berniesanders.com/issues/medicare-for-all/

[Edited on August 1, 2018 at 12:56 PM. Reason : .]

8/1/2018 12:52:13 PM

LoneSnark
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Quote :
"It's sad that you're afraid of single payer solely because you believe employers will pocket the savings. Do you want to keep living in a world where the rich have you by the balls? Or do you want to hold them accountable and make the world better for your kids?"

Hi-larious. Health insurance companies make very little money, nothing compared to the costs. Much of the system is operated not-for-profit besides.

The rich ripping us off are the doctors and nurses that have banned competition, the lawyers which run middle management, and the chronic waste of expensive labor that the system uses. Single payer will do nothing to curtail the current labor monopoly (the AMA operates as a state sponsored labor union) or the rest of the inefficiencies, so what we'd gain is maybe a reduction in the growth of medical wages as the bilateral monopoly entrenches against any change what-so-ever from the status quo. Government bureaucrats want to put more nurse practitioners seeing patients? AMA Lawyers will sue just as vociferously as they do today when corporations try to break their monopoly.

[Edited on August 7, 2018 at 8:15 PM. Reason : .,.]

8/7/2018 8:14:16 PM

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