What can we agree on regarding health care?

[werepossum]

I believe a single payer is the only way forward on this. I think it's crystal clear that the free market, or capitalism, works for luxury goods but not for necessities.

I disagree. The free market works better than anything for necessities because only the free market can introduce true competition. Where I think the free market breaks down in when costs get ruinous. The beauty of the free market is that every exchange only takes place when both parties are receiving something they value more than what they are giving up. But it's entirely possible that we need discrete medical care with a cost far above any insurance premiums we could ever pay back, not to even mention treatments with costs above the cost of attracting another replacement customer.

Back before health insurance was a thing, medical treatments were necessarily limited to what value an individual could repay. Health insurance came about to allow more expensive treatments, with the understanding that many individuals would pay a little bit and only a few individuals would need this very expensive treatment. The differential cost magnitude (i.e. the value an individual can pay versus the value of what that individual needs) dictates where the free market breaks down, not whether something is a necessity.

 

[Fanatical Meat]

I disagree. The free market works better than anything for necessities because only the free market can introduce true competition. Where I think the free market breaks down in when costs get ruinous. The beauty of the free market is that every exchange only takes place when both parties are receiving something they value more than what they are giving up. But it's entirely possible that we need discrete medical care with a cost far above any insurance premiums we could ever pay back, not to even mention treatments with costs above the cost of attracting another replacement customer.

Back before health insurance was a thing, medical treatments were necessarily limited to what value an individual could repay. Health insurance came about to allow more expensive treatments, with the understanding that many individuals would pay a little bit and only a few individuals would need this very expensive treatment. The differential cost magnitude (i.e. the value an individual can pay versus the value of what that individual needs) dictates where the free market breaks down, not whether something is a necessity.

Or as I like to say, medical billing can't be negotiated in an emergency or even a crisis. Billing currently works like the one gas station that has gas after a natural disaster then starts selling it for $60 per gallon. Does luck make someone a Captain of Industry or is he just greedy?

 

[piasabird]

The reason why medicare and medicaid work is because they are supplemented. The hospitals can afford to help because other people are footing the bill with their paid insurance plans. It is also very expensive and prone to abuse. Any plan the government has that penalizes me when the company I work for wants to pay for better insurance and makes me pay more for less coverage is Shit.

 

[readymix]

I believe a single payer is the only way forward on this. I think it's crystal clear that the free market, or capitalism, works for luxury goods but not for necessities.

it's a capital intensive service industry and without some truly disruptive tech or bigly gains in productivity it's going to keep marching higher.

 

[Pulsar]

The reason why medicare and medicaid work is because they are supplemented. The hospitals can afford to help because other people are footing the bill with their paid insurance plans. It is also very expensive and prone to abuse. Any plan the government has that penalizes me when the company I work for wants to pay for better insurance and makes me pay more for less coverage is Shit.

We can both agree on that one. The "Cadillac" health care tax is total bullshit.

 

[HamburgerBoy]

it's a capital intensive service industry and without some truly disruptive tech or bigly gains in productivity it's going to keep marching higher.

It's really not, no more than any other current big $$$ tech industry. Big pharma companies spend more on advertising and lawyers as they do actual R&D. Monopolies disincentivize innovation and encourage IP hoarding. We have an anti-free market medical system and the tax payers get to enjoy directly subsidizing companies to produce inferior products. The most amazing, efficient, cure-all-cancer drug could be discovered and our system would figure out a way to make sure that trillions of Part D dollars went to it for half a century. It's not a new phenomenon either; the Wright Brothers were total jackasses that, once possessing a patent on the fundamentals of an airplane, ensured that any innovations on the airplane for the next 20+ years were either stalled or forced to dole out big royalties. Now thanks to the FDA, corporations don't even have to worry about patent expiry.

I'm a believer in IP and I think as automation takes over, IP will only become a bigger part of our economy, but 20 years is a dumb arbitrary number that is increasingly inappropriate as researchers out-scoop each other by mere months. Once the costs of an invention have been recouped with a bit of profit on top (can't estimate, but less than an order of magnitude would probably be a good starting point), there's no reason to not allow it expire to the public domain.

 

[readymix]

$$$ .

HamburgerBoy, shorten the exclusivity and put a cap on profits? I'll have to think about that.

 

[VRAMdemon]

Those skimpy policies sucked pre-ACA, despite what you might think. They also had maximum payout caps - end up in the ICU for a few days, congratulations, you just hit your cap and are now facing medical bankruptcy. Or your doctors in the hospital weren't covered, only the hospital was covered, etc...

Yeah, I agree, but the point I was trying to make was that these policies used to exist and some companies don't carry them anymore. To some, this type of policy was "acceptable" coverage. It gives the open door for "since the ACA I lost my coverage I loved and was happy with" criticism.

Many of the "plans people loved" weren't cheap catastrophic plans. Pre-Obamacare, some insurers sold small "bridge policies" to cover the deductible on a real insurance policy. The plans were inexpensive, often well under $100 a month. And they covered a lot of routine services, doctor visits , eyeglasses, prescription drugs... with low or no copays and no deductible. The only catch was the annual maximum benefit which was usually around $2000.

Now these plans were not intended as primary insurance. In fact, they had big "This Plan Is Not Insurance" warnings on them. But some people got the bright idea to offer them up to low income employees of companies like McDonalds and Walmart as insurance.

And the employees LOVED them and understandably so. Here was this insurance plan that paid for every bit of routine care and it cost under $100 a month. And the large majority of those policy holders, many of them young, never experienced a significant medical event that would expose the fatal flaw of those policies.

 

[Fern]

I would actually go the opposite way, where everyone has universal catastrophic coverage to cover things like cancer and then everything else is paid for by HSAs or whatever. The primary cost driver in US health care is not the routine stuff, it's the end of life care, the cancer care, etc. This is where single payer can really shine if we let it.

Yeah. I agree with this.

Fern

 

[agent00f]

Another poster in another thread said they supported single payer health care which surprised me and at least one other poster and it left me wondering; how many people support a universal, single payer health care system?

In order to gauge the support of such a plan we first need to agree on what universal, single payer means. For the purpose of this poll, universal means health care access to all US citizens. There is debate about whether it makes sense to cover other people as well and in other countries non citizens are indeed able to access some health care benefits but for the purpose of this discussion and to get as broad as an agreement as possible, I'll narrow the scope of the definition.

Single payer, again, for the purposes of this discussion means that everyone pays something. "Everyone" means anyone receiving an income, so employees and employers.

Based on how every country (as far as I know) implements health care, universal/single payer also means price controls of some sort. This means price controls for both suppliers, providers, doctors and anything else.

Access to health care is defined as access to both preventive care and treatment for basic health related items up to and including catastrophic care. Voluntary procedures/care such as cosmetic surgery are not covered.

Of course all the above can be debated and the degrees to which they apply can be debated as well but for the purpose of this poll, these are the base definitions we are using.

So, who supports universal/single payer health care?

What this thread demonstrates is that policy realities are relatively uncontentious, and the stark contrast to the politics of ignoring those realities, generally to side with tradition/loyalty.

 

[Brainonska511]

Yeah, I agree, but the point I was trying to make was that these policies used to exist and some companies don't carry them anymore. To some, this type of policy was "acceptable" coverage. It gives the open door for "since the ACA I lost my coverage I loved and was happy with" criticism.

It may have only been acceptable to those people because they never had to use it to find out how truly crappy it was.

 

[WHAMPOM]

There are many countries with working health care systems, just adopt one that works and implement it here. Japan comes to mind, but first we need our Congressmen to spit out the nut sacks of the insurance, drug, medical big money interests and do it.

 

[piasabird]

Anything the US Govt touches turns to cow dung.

 

[Brainonska511]

Anything the US Govt touches turns to cow dung.

Why do you hate the troops and military? You some kinda communist?

 

[shortylickens]

Can we all agree, that for a party that had 7 years of promising to replace Obamacare with something better, billions of dollars in think tank funding, and control of Congress, the bill they have finally came up with is pretty pathetic? The Republican mountain gave birth to a mouse.

No, we cant agree on that.
And I'll tell you why.

The 62 million morons who somehow convinced themselves Donald Trump should actually be president are sure as hell not going see anything wrong with congress failing to find something better or wasting money in the process. They will NEVER admit the monster they unleashed is their fault.
They will find some fantastic way to blame everything on anyone else, despise the Republicans controlling the house, the senate, the oval office, and (arguably) the supreme court.
And Kellyanne Conway is their cheerleader.

 

[Svnla]

I don't care if you are D, R, I, or in between but the cost of health care in the US is rising too fast and it can not go on like this. Unsustainable.

Me, single, no kid or spouse, in decent shape and health, never have a claim, high deductible ($5K) plan with Blue Cross Blue Shield and the latest bill was about slightly double for what I paid just about 4-5 years ago. Each year around January, the bill just go up like clockwork, no exception.

It is scary to think about the cost about 5-10 years later or if I am married and/or have kid(s) or my health goes south.

I just wish there is a real honest discussion about health care from Congress instead of scare tactics and smoke and mirror to spin.

 

[Jhhnn]

No, we cant agree on that.
And I'll tell you why.

The 62 million morons who somehow convinced themselves Donald Trump should actually be president are sure as hell not going see anything wrong with congress failing to find something better or wasting money in the process. They will NEVER admit the monster they unleashed is their fault.
They will find some fantastic way to blame everything on anyone else, despise the Republicans controlling the house, the senate, the oval office, and (arguably) the supreme court.
And Kellyanne Conway is their cheerleader.

Or we can hope that Trump's win is the result of temporary propaganda induced mass insanity & a quirk of the electoral college system. I figure lots of Trump voters are already asking themselves "WTF was I thinking?"

And we're less than 2 months into it. Within their Free Market taxes are for little people ideological framework Repubs can't even begin to deliver wrt inclusive healthcare coverage.

The only way to deliver that is thru taxes, redistribution & equitable risk sharing through everybody's lifetimes. That's the method of the ACA & single payer as well.

 

[wirelessenabled]

"What are you willing to give up? Will you wait for 3 years to have hernia surgery? How do you implement a system without harming people by breaking care? This is an infinitely harder thing than the ACA, probably more than any other project in US history."

I have lots of Canadian family. None of them have the problems you describe.

The big problem with the US heath care is that insurance coverage is low and costs are high.

Of course the insurance companies take about 20-30% of the US health care total bill of $3 trillion per year. Medicare does the same work for less than 2% of the bill.

A big start to solving the health care problem in the US is putting the insurance companies out of the game. Savings there of up to $1 trillion per year.

 

[ivwshane]

"What are you willing to give up? Will you wait for 3 years to have hernia surgery? How do you implement a system without harming people by breaking care? This is an infinitely harder thing than the ACA, probably more than any other project in US history."

I have lots of Canadian family. None of them have the problems you describe.

The big problem with the US heath care is that insurance coverage is low and costs are high.

Of course the insurance companies take about 20-30% of the US health care total bill of $3 trillion per year. Medicare does the same work for less than 2% of the bill.

A big start to solving the health care problem in the US is putting the insurance companies out of the game. Savings there of up to $1 trillion per year.

I think the big start would be Americans having a serious debate on whether or not they think health care is a right or not. If we can't agree on that then any solution is bound to fail or be sabotaged.

 

[brycejones]

Anything the US Govt touches turns to cow dung.

Derp

 

[mrjminer]

Free market is the way to go. Eliminate Obamacare. Eliminate all of the additional funding for Medicaid / medicare that has been added over the years and put it at a normal, sane amount. Resolve issues with veteran's healthcare. Allow the insurance companies to set the prices that allow them to compete and offer a slew of plans to whoever they want for whatever they want. Allow doctors and hospitals to charge whatever they want; if hospitals overcharge, insurance companies will resolve with their agreements. Eliminate all funding and subsidies for hospitals and medical research.

Remove the government entirely. The free market will resolve.

 

[TeeJay1952]

Free Market means turning folks away for treatment if they don't have money or permission from Insurance. Do we have Chicago Fire look for cards before transport or does Chicago Med just have a separate waiting room for "Waiting to die, no insurance."
Are you looking forward to Chicago Concentration Camp?

 

[Meghan54]

Ahahahahahahahaaaaaaa......gotta catch my breath here...........hahahahahahahahahahahaaaaaaaaaaa!!!!

Free market is the way to go. Eliminate Obamacare. Eliminate all of the additional funding for Medicaid / medicare that has been added over the years and put it at a normal, sane amount. Resolve issues with veteran's healthcare. Allow the insurance companies to set the prices that allow them to compete and offer a slew of plans to whoever they want for whatever they want. Allow doctors and hospitals to charge whatever they want; if hospitals overcharge, insurance companies will resolve with their agreements. Eliminate all funding and subsidies for hospitals and medical research.

Remove the government entirely. The free market will resolve.

 

[ivwshane]

Free market is the way to go. Eliminate Obamacare. Eliminate all of the additional funding for Medicaid / medicare that has been added over the years and put it at a normal, sane amount. Resolve issues with veteran's healthcare. Allow the insurance companies to set the prices that allow them to compete and offer a slew of plans to whoever they want for whatever they want. Allow doctors and hospitals to charge whatever they want; if hospitals overcharge, insurance companies will resolve with their agreements. Eliminate all funding and subsidies for hospitals and medical research.

Remove the government entirely. The free market will resolve.

We had "free market" and it not working is exactly how we got the ACA.

 

[Thebobo]

Free market is the way to go. Eliminate Obamacare. Eliminate all of the additional funding for Medicaid / medicare that has been added over the years and put it at a normal, sane amount. Resolve issues with veteran's healthcare. Allow the insurance companies to set the prices that allow them to compete and offer a slew of plans to whoever they want for whatever they want. Allow doctors and hospitals to charge whatever they want; if hospitals overcharge, insurance companies will resolve with their agreements. Eliminate all funding and subsidies for hospitals and medical research.

Remove the government entirely. The free market will resolve.

Wonder how old are you, roughly and how financially secure you are, get an inheritance?