Do Democrats Know How Radical Bernie Sanders' 'Medicare For All' Plan Is?

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Xanthippe_Voorhees said:
We spend more on our healthcare because prices are not controlled by the market and completely arbitrary. Our litigation system is out of control. Single payer healthcare would only make things worse until they fix that.
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Not only that, but cost aren’t counted the same way in different systems, and some of the systems that seem to be “single payer” really aren’t. In some European countries, medical school is free, malpractice insurance is paid by the government and they have separate court systems for malpractice cases. None of that is counted in the “cost of care”. In some countries, the fee for service is paid up front by the patient who then has to get reimbursed by the government, if he/she can get it done. Some don’t bother for minor things.

And many of them are “two-tier”. There is the “government system” and the “private system”. The first is government-paid, usually with deductibles. The second is “private pay”, either by the patient or an insurer. The second is, of course, better than the first.

Some of those “single payer” systems are basically “Medicaid with deductibles”, and are about what one would expect.

And in some, illegal aliens get no reimbursement. It’s cash up front or no service for most things.
 
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Ridgerunner said:
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Xanthippe_Voorhees:
We spend more on our healthcare because prices are not controlled by the market and completely arbitrary. Our litigation system is out of control. Single payer healthcare would only make things worse until they fix that.
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Not only that, but cost aren’t counted the same way in different systems, and some of the systems that seem to be “single payer” really aren’t. In some European countries, medical school is free, malpractice insurance is paid by the government and they have separate court systems for malpractice cases. None of that is counted in the “cost of care”. In some countries, the fee for service is paid up front by the patient who then has to get reimbursed by the government, if he/she can get it done. Some don’t bother for minor things.

And many of them are “two-tier”. There is the “government system” and the “private system”. The first is government-paid, usually with deductibles. The second is “private pay”, either by the patient or an insurer. The second is, of course, better than the first.

Some of those “single payer” systems are basically “Medicaid with deductibles”, and are about what one would expect.

And in some, illegal aliens get no reimbursement. It’s cash up front or no service for most things.
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Canada is a mostly single-payer, but there’s a thriving, if at times controversial, private care system. Here in BC, I don’t get drug or dental coverage through the public system, but I do through a supplementary company plan. So, if I need to get glasses, the public system won’t pay for it (unless I’m on welfare), but if I suffer a stroke, the most I am likely to get billed is the ambulance ride (which, oddly enough, isn’t usually covered).

However, at every hospital in BC that I’ve been in, right at the front desk, there’s a list of costs; cost of a room per day, cost of certain common procedures, and so forth, and if you are not covered by BC medical or, through agreements with the other provinces, by another province’s health care, you’re going to get sent a bill. So if you’re in Canada, whether as a legal visitor, or illegally, and you end up in a hospital, you’re going to be billed. If you’re a landed immigrant (you have Canadian residency rights), I believe you can get coverage (whether there is a premium involved depends on the province). I believe refugees are automatically covered until they are allowed to look for work.

That would seem to me be a reasonable model for the US. Rather than one big Federal system, you have fifty different medical systems, much as there are now, but the “single payer” is really a set of agreements between all the states to cover each others’ citizens for some baseline set of treatments. It doesn’t have to be equal; some states might pay for some dental work, some might not, but the point is to cover the most serious and medically-necessary procedures.
 
That’s a rarity. My grandfather had to wait a month to get a lump removed from his neck, because the two hospitals in the area both had massive wait-times.

Socialism is also deeply rooted in Canadian society, also, which is the responsibility of the New Democrat, Labour, and modern Liberal movements within the political system. I’d never suggest removing it (though I wish we could), because socialism collapses upon itself eventually, it would be satisfying to see that the path towards forming independent hospitals were easier under the current conditions.
 
niceatheist said:
However, at every hospital in BC that I’ve been in, right at the front desk, there’s a list of costs; cost of a room per day, cost of certain common procedures, and so forth, and if you are not covered by BC medical or, through agreements with the other provinces, by another province’s health care, you’re going to get sent a bill. So if you’re in Canada, whether as a legal visitor, or illegally, and you end up in a hospital, you’re going to be billed. If you’re a landed immigrant (you have Canadian residency rights), I believe you can get coverage (whether there is a premium involved depends on the province). I believe refugees are automatically covered until they are allowed to look for work.
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I clipped your quote and bolded this line. THIS is exactly why America is not ready for single-payer or government for all + private for some. Hospitals literally don’t have one cost for anything…not even a bandaid, never mind full treatment for a stroke. What they charge someone paying “cash” through a plan like Samaritan’s Purse, what they charge an Anthem subscriber or a United Health subscriber or a Cigna subscriber or a Medicare subscriber can vary by the thousands. And it’s not consistent. Cigna may have better ultrasound coverage but Anthem may get X-rays on the cheap.
 
Xanthippe_Voorhees said:
Hospitals literally don’t have one cost for anything…not even a bandaid, never mind full treatment for a stroke. What they charge someone paying “cash” through a plan like Samaritan’s Purse, what they charge an Anthem subscriber or a United Health subscriber or a Cigna subscriber or a Medicare subscriber can vary by the thousands. And it’s not consistent. Cigna may have better ultrasound coverage but Anthem may get X-rays on the cheap.
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That’s for sure. All hospitals have a charge set that is called “Reasonable and Necessary”. It’s an artificial price schedule that applies only to self-pays who can afford it, and out of network insurers that can’t talk them out of it.

Medicare is supposedly about 60% of “Reasonable and Necessary”. Medicaid is supposedly about 1/3 of it. But the hospitals and clinics get to build all their costs into Medicare charges, so the “real” price of everything is closer to Medicare, but even then it is inflated.

There was a time in my life when I made network deals for a large self-insurer. It was an industrial giant that self-insured in health insurance. I ALWAYS got a discount from Medicare rate, and the providers were glad to get the business. The whole pricing system is a crock. One item I still remember is a whole-spine MRI. "Retail’ at that time was about $1500. They gave it to me for $300 and didn’t bat an eye. At the time, they charged Medicaid more than that.

Real costs also vary from place to place. I live in a fairly low-cost part of the country. The medical provider complexes are very, very well-equipped and even ornate. I remember being invited to lunch in the bigwigs’ dining room during negotiations, and the gold-plating (not to mention the food) was jaw-dropping. They have a lot of money to throw around. It was actually kind of amusing. Some of the super-specialists were part of the complex negotiating team, and I could almost see them salivating over the prospect of a whole bevy of new patients to charge for services. Part of all that is keeping everything and everybody cranking cash. So the MRI I mentioned above was undoubtedly idle part of the time, so to keep it making cash constantly, they were willing to reduce from the bogus “Reasonable and Necessary”. And they want the surgeons in the surgery suite doing one surgery after another all day long, not sitting in their offices watching TV.

I also remember as part of my varied life, when I was in banking. I was approached by a broker offering to sell bonds to build a big new specialty clinic for one of the big complexes. I was mildly interested, but then the broker called later and told me the bond issue was off. They paid for it out of their own cash. And it was quite a clinic. I admire it still.
 
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Xanthippe_Voorhees said:
THIS is exactly why America is not ready for single-payer or government for all + private for some.
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Realistically this won’t happen. Not for all anyway. They may end up expanding to 55 or 50 and go from there. To do it all at once would shock the system do doubt.
 
You seem (correct me if I am wrong) that everyone will be given the same kind of care that those on Medicare get now. That does not take into account that with so many more on the plan that there will be rationing of services. I have had personal experience, although it is only one case, that certain tests that are readily available now in a physician’s office may not continue to be present when a standard fee is assigned by the government and tests are not included in that fee.

I certainly believe that anyone who cannot afford care should be helped by the government, but I don’t think we can afford Medicare for all.
 
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I do. It means if it is important to people the state should make sure it is done.
 
What is the objection to making Medicare optional?

In other words, let everyone seek out their own medical care and medical financing.

So, if you are able to find a Health Savings Account and/or a catastrophic insurance plan, then why not buy those?

There are many local options.

Let hospitals sell medical insurance.

If someone is unable to find their own program, then let them use Medicare.

Also important to not BAN an HSA or catastrophic plan. This went on before ObamaCare. YOU were legally prevented from getting your own program.

There are LOTS of options available, so shop around.

You can use a cash program with a backup plan such as Solidarity HealthShare. There are several of those.

Why should Sanders and Folkahontas and Kamala Harris force us to use Medicare, when there are LOTS of options available?
 
Vonsalza said:
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ucfengr:
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Vonsalza:
First world countries with socialized medicine beat the US pretty handily in per capita cost, infant mortality and life expectancy. So I’m not sure you’re objectively correct here.
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This is a very deceptive statistic. There isn’t a uniform method for measuring infant mortality. The US uses a much more liberal method of recording infant mortality than other countries. Life expectancy is tricky too. Americans of European or Asian descent have life expediencies that are very similar, if not superior to their European or Asian cousins. Americans of African descent actually have superior life expediencies to their African cousins. The differences are better explained by genetic and lifestyle differences than to quality of health care.
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It’s not the only statistic cited. But I suspect in any case:

When the facts don’t support you, “deny, deny, deny”, right? :roll_eyes:
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If you actually look at the data, what you find is that it doesn’t support your “facts”, which makes their classification as “facts” suspect.
 
I think Democrats do know how radical it is, which is why only a handful have signed on to cosponsor it. If single payer can’t pass in California or Vermont, there’s no way it’s going to pass the House and Senate.
 
marybobo said:
You seem (correct me if I am wrong) that everyone will be given the same kind of care that those on Medicare get now.
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Not at all. Even those who are on Medicare right now do not get the same kind of care. Doctor skills vary, hospital services vary, etc. You still might have to travel a long way to get certain cancer treatments, for example. There may be lines of patients before you get treatment. So what’s the solution for equality? I don’t think there is one.
 
Ridgerunner said:
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tomarin:
Wouldn’t income (i.e. wealth) be a better predictor of life expectancy than race? That is, I would imagine white but poor Appalachians to name one example wouldn’t have a life expectancy superior to their European cousins?
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Undoubtedly income would have some effect. But it’s entirely possible that the average life expectancy in some backwoods West Virginia town is higher than that in Paris IF the people in WVa are older, on average than Parisians. Life expectancy is a statistical thing, and does not tell you anything about average longevity. The older we get, the longer is our life expectancy. A 70 year old’s “life expectancy” is ALWAYS higher than that of a 20 year old, because of the risks of getting from 20 to 70. A lot of things can kill you in 50 years.
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That’s for sure.
 
marybobo said:
If you believes that they will get really good healthcare under the Bernie system, they are fooling themselves. There will be rationing and the quality of care will be dumbed down to the lowest common denominator.
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Newsflash: There has always been rationing in the American for profit system based on how much a person could afford.
 
Since we are talking about retirees, there is 401k money, there is home equity, etc.
 
“RAdical” ha ha ha
THE ENTIRE REST OF THE FIRST WORLD HAS WHAT SANDERS WANTS FOR US.
 
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