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Joyful_Song
Guest
Is there a way to make single payer work so that everyone or most everyone supports it?
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J
Joyful_Song
Guest
Here’s a good analysis of the VA system, saying that while they’ve had problems they address them and overall the system has served the people.Sorry to break it to you, but single payer will not be a panacea. If you want an example of a government run health care program operating today here in the US, take a look at the VA system. I have absolutely no faith that the outcomes will be any different for the rest of us.
On a personal not my father received care at the Phoenix VA hospital and he actually wrote an appreciation letter about his doctors for the great care he received.
forbes.com/sites/harlankrumholz/2014/05/23/3-things-to-know-before-you-rush-to-judgment-about-va-health-system/#aa9bb9e55e43
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ucfengr
Guest
I don’t think so. The magnitude of the bureaucracy that would be needed to manage the health care of 350M people spread out over a continental land mass is bigger than anybody understands. It barely works in Canada, which has a 1/10 the population of the US, and which has the benefit of the US as an outlet.Is there a way to make single payer work so that everyone or most everyone supports it?
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Joyful_Song
Guest
Well, I still see people in congress who are not as cynical as you and are willing to work for a better change.As a person who works with the federal government, we’ll make it worse for you, but we’ll all make a ton of money on it. DC Metro thanks you for paying our ridiculous salaries.
Also, lol at “bipartisan”. Like “compromise” in DC it’s a useless word that means “Give me everything I want, and you get to vote for it.”
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Joyful_Song
Guest
wow, here’s an inspiring speech from Senator John McCain. There is a video of the whole speech on the senate floor.
washingtonpost.com/news/the-fix/wp/2017/07/25/were-getting-nothing-done-john-mccains-no-holds-barred-lecture-to-the-senate-annotated/?utm_term=.5b66780ec0ca
washingtonpost.com/news/the-fix/wp/2017/07/25/were-getting-nothing-done-john-mccains-no-holds-barred-lecture-to-the-senate-annotated/?utm_term=.5b66780ec0ca
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Ridgerunner
Guest
Under Obamacare, then, the “lower tier” (uninsured) is 20 million people; perhaps more.A two tiered health care system as your described is not so bad. It is better than some people getting no health care at all. In a way, that is also a two-tiered system where the lower tier is zilch.
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Ridgerunner
Guest
The only health program the government actually administers is VA. All the rest of them are managed by private insurance companies.I don’t think so. The magnitude of the bureaucracy that would be needed to manage the health care of 350M people spread out over a continental land mass is bigger than anybody understands. It barely works in Canada, which has a 1/10 the population of the US, and which has the benefit of the US as an outlet.
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Ridgerunner
Guest
I sincerely doubt it. The closest to it that anyone might devise is a two or three tiered system. Good care for a few, with terrible and exasperating care for everybody else, combined with significantly higher taxes. “Medicaid for the masses”. That’s what single payer would be.Is there a way to make single payer work so that everyone or most everyone supports it?
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ProVobis
Guest
Yes, but first don’t call it “single payer” because many would probably freak out. Call itIs there a way to make single payer work so that everyone or most everyone supports it?
“Medicare for all” since Medicare is a known quantity. Or Medicaid for that matter.
J
Joyful_Song
Guest
yes that’s important to call it something everything recognizes and knows they’re talkng about the same thing. Someone else mentioned that people were totally against repealing “Obamacare” but ok with “Affordable Care Act” , not realizing it’s the same thing.Yes, but first don’t call it “single payer” because many would probably freak out. Call it
“Medicare for all” since Medicare is a known quantity. Or Medicaid for that matter.
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Joyful_Song
Guest
And I realize this too. Already the system we have is like this. My father has the most excellent insurance that covers everything and it was grandfathered in when he retired, and my husband and I are self employed small business and we have a plan with a hugely high deductible. There has to be a fair plan where everyone pays in and gets the same care. Repealing ACA without having a concise plan is going to leave millions of people vulnerable.I sincerely doubt it. The closest to it that anyone might devise is a two or three tiered system. Good care for a few, with terrible and exasperating care for everybody else, combined with significantly higher taxes. “Medicaid for the masses”. That’s what single payer would be.
medicareforall.org/pages/Answers
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OraLabora
Guest
No this is false, at least in Canada. The everyday and elective stuff tends to drag on. The serious stuff gets dealt with promptly, at least in Quebec. My wife is family doctor in the system, and I used to work in IT in the health care system, so we have more than a bit of experience with the system. She has been practicing for 33 years since residency.It may work well enough for everyday care, but I believe that a serious medical problem is quite another matter. And the countries you mentioned have much smaller populations than we do and I wager not near as large a percentage of their population on welfare.
No human system is perfect and there are failures.
The prospect though, of 30+ million people unable to get coverage in the US is unconscionable in such a wealthy country. If I were president, I couldn’t sleep at night with that on my conscience.
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Sy_Noe
Guest
I agree but supposedly Trump is making America great again.On the flip side, look at Canada, UK, Eurozone, Scandinavia… all have single payer and it works quite well over there. If they can do it, you’d think the supposed greatest country on Earth could do it too.
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Sy_Noe
Guest
Some of those are healthy people who choose not to purchase coverage. The lower tier under the Republicans would be sick people who won’t be able to afford proper care or the tens of millions who are projected to lose their coverage.Under Obamacare, then, the “lower tier” (uninsured) is 20 million people; perhaps more.
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Ridgerunner
Guest
With Obamacare, it is estimated that approximately that number don’t have health insurance. So perhaps Trump really can’t sleep at night knowing that.No this is false, at least in Canada. The everyday and elective stuff tends to drag on. The serious stuff gets dealt with promptly, at least in Quebec. My wife is family doctor in the system, and I used to work in IT in the health care system, so we have more than a bit of experience with the system. She has been practicing for 33 years since residency.
No human system is perfect and there are failures.
The prospect though, of 30+ million people unable to get coverage in the US is unconscionable in such a wealthy country. If I were president, I couldn’t sleep at night with that on my conscience.
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Ridgerunner
Guest
Ensuring a level playing field for all presents enormous obstacles, not the least of which is employment-based coverage. It cost less per capita for the same product in the “private market” (which is not so private anymore anyway). That’s due to the “well worker effect”. If you’re very sick, you can’t work, so you go out of the employment-based system.Some of those are healthy people who choose not to purchase coverage. The lower tier under the Republicans would be sick people who won’t be able to afford proper care or the tens of millions who are projected to lose their coverage.
And yet, people who have it like it, and would like it even more if it returned to the status quo ante Obamacare when it didn’t have all of the mandates. That’s a huge number of people; approximately half the population.
So are the Dems really prepared to undo the greatest inequity of all and infuriate half the population? I don’t think so. And are the elderly going to be pitched off Medicare into a single payer system resembling Medicaid? Adding the two groups together, that’s most of the population.
“Medicare for all” or even “Medicaid for all” is an interesting slogan, but it’s just a slogan. Both Medicare and Medicaid benefits are “discounts” to the market. Medicaid reimbursement is about 1/3 of regular pricing, and Medicare is about 2/3. So the discounts can’t continue if the whole country is on one or both.
Obamacare deftly sidesteps those problems for the most part. For the elderly, there is no change of substance, though Obamacare originally called for the end of Medicare Advantage. It puts about 17 million more people on Medicaid, some of whom would have had employment-based insurance and probably aren’t happy about this outcome.
The rest either dodge the system and pay the penalty (or don’t). There are undoubtedly millions of those folks. Or they are stuck in the “exchanges”; an income-redistribution plan whereby some are subsidized and some are not, but all are in a high-cost-per-person “pool” that’s really devastating to those who aren’t subsidized and to some of those who are only partially subsidized. It’s a high cost pool because it has millions of reasonably healthy people pooled with a lot who are not; in a pool that does not reflect the risk of the population at large, but is much higher.
Perhaps if the country really doesn’t want to return to the previous system, in which the great majority were happy with what they had but in which some just didn’t have insurance at all and couldn’t get it, the only answer is to deliberately create the “two tiers”.
One would be “Mega-Medicaid”; same thing but with more people. The rest would be the free market. As is the case in most countries that have “tiers”, the quality would be in the latter, but that just seems to be inevitable.
It would be best if the two tier system was cost-analyzed and put to a plebescite. "Understanding your taxes will go up by “X”, and people making under “Y” or who are uninsurable will go on Medicaid, do you support “MediTier”?
I have no idea how the vote would come out, but my guess is that it would fail.
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Ridgerunner
Guest
How many are “double-counted”, and under what plan? There is no definite Repub plan, at least not yet. And how many who now don’t have coverage who would buy it if it suddenly became affordable?Some of those are healthy people who choose not to purchase coverage. The lower tier under the Republicans would be sick people who won’t be able to afford proper care or the tens of millions who are projected to lose their coverage.
One has to realize there are people stuck in the “exchanges” who would pay less in a free market; possibly a lot less, because the composition of the “pool” they are in would almost certainly change favorably.
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ucfengr
Guest
Medicare isn’t all that great, which is why anybody who can afford it has supplemental coverage to cover the enormous number of things Medicare doesn’t. Medicaid is even worse due to the low reimbursements. Most doctors won’t even take a Medicaid patient and those that do can only afford to take a very low number.Yes, but first don’t call it “single payer” because many would probably freak out. Call it
“Medicare for all” since Medicare is a known quantity. Or Medicaid for that matter.
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mary_bobo
Guest
That was not my experience while we lived there. My serious “stuff” did not get prompt attention thus I spent a week in ICU and two more weeks in a hospital in August in an un-air conditioned room. Meanwhile, two of my husbands branch managers in two different areas of the country died waiting for by-pass surgery. I do not deny the experience of your wife and yourself, just noting that mine was not the same.No this is false, at least in Canada. The everyday and elective stuff tends to drag on. The serious stuff gets dealt with promptly, at least in Quebec. My wife is family doctor in the system, and I used to work in IT in the health care system, so we have more than a bit of experience with the system. She has been practicing for 33 years since residency.
No human system is perfect and there are failures.
The prospect though, of 30+ million people unable to get coverage in the US is unconscionable in such a wealthy country. If I were president, I couldn’t sleep at night with that on my conscience.
T
Theo520
Guest
I’m always astounded why people think single payer is an easy answer to the problem.Sorry to break it to you, but single payer will not be a panacea. If you want an example of a government run health care program operating today here in the US, take a look at the VA system. I have absolutely no faith that the outcomes will be any different for the rest of us.
Changing who processes your insurance premium check has no impact on the cost of delivering the services. For single payer to work, we would have to make all the healthcare workers govt employees.
What we need is real reform that reduces the cost of delivering healthcare services.
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