Why single payer would work despite protest claims

[ChunkiMunki]

it's quite apparent health care cannot be run as a free-enterprise, unless we just act cold-hearted and deny everyone care unless they produce their health insurance card prior to receiving any treatment, like the old fire-insurance model. My guess is in less than 50 years we will all pay out of our paychecks a "health insurance tax" and have a single-payer system.

 

[Hayabusa Rider]

it's quite apparent health care cannot be run as a free-enterprise, unless we just act cold-hearted and deny everyone care unless they produce their health insurance card prior to receiving any treatment, like the old fire-insurance model. My guess is in less than 50 years we will all pay out of our paychecks a "health insurance tax" and have a single-payer system.

Health care will continue to rise as a percentage of GDP. If you were to do research you would find that the US is NOT at the top (nor close) of the percentage of increase in insurance costs. Many industrialized countries are set to eclipse us, and it's all due to demographics.

Anyone who say's differently has a poor grasp of reality, and demonstrably so.

 

[ebaycj]

I don't understand the reference to Wall Street.

I do not think of insurance as WS type business, I think of banking, hedge funds, arbitraging, selling stock and other financial products.

EVERY company with a market cap of > $1B is a "Wall Street [company]", because their current share price, and Wall Street's future expectations thereof, are the ONLY things that matter to such a company.

 

[ShawnD1]

He believes that we all should pay taxes for a single payer program like Canada. Then let private insurance companies compete if they want to. Many people claim that this would be the death to the health insurance industry and I brought that point up to him. At which point here is a few counter points he brought up.

People think that because they are profoundly retarded. It takes 1 minute to check this on google.

Health insurance companies operating in Canada
-Sun Life
-Blue Cross
-Manulife
-Green Shield
-Industrial Alliance Pacific
-Cooperators
-NorthShore


Australia has UHC, so here's a list of Australian health insurance companies:
-Medibank
-AHM
-Australian Unity Health
-SGIC


Google is difficult to use

 

[Schadenfroh]

To tell you the truth, I would prefer an improved version of Medicare being available to everyone, but we would need to pass tort reform first to reign in the lawyers to keep costs down. But, I would have a hard time reconciling either of those things with the constitution if implemented at the federal level.

 

[nonlnear]

To tell you the truth, I would prefer an improved version of Medicare being available to everyone, but we would need to pass tort reform first to reign in the lawyers to keep costs down. But, I would have a hard time reconciling either of those things with the constitution if implemented at the federal level.

There is a bill pending in the house to do just that. It was introduced by Alan Grayson. Quite simply it opens Medicare to everyone for a revenue neutral premium, to be determined by age alone. The bill is four pages long.

 

[Patranus]

Quite simply it opens Medicare to everyone for a revenue neutral premium, to be determined by age alone. The bill is four pages long.

How can you determine revenue neutral premiums if they are based only on age?

 

[nonlnear]

How can you determine revenue neutral premiums if they are based only on age?

Quite simply you tell an actuary to calculate a revenue neutral premium. It's not hard. You get a higher premium for most people if you aren't allowed to discriminate based on other factors, but it's a very simple thing to do. The entire BCBS alliance was originally founded using only age (and I think maybe gender) as a determiner of premiums. It was only when other companies started offering lower premiums to select groups that the "age only" model broke down. Then the BCBS companies started to do the same in order to win back their lost customers, blurring the line between the for profits and the not for profits. Now they all look the same.

The two big differences are that medicare has lower reimbursement levels than insurance companies so they might be able to still offer a premium that many people would find affordable. (Whether they could find a provider to accept Medicare is a separate issue.) Also the Medicare system wouldn't have to apologize to a board or shareholders if their "customer base" shrunk.

 

[blackangst1]

Arnt you just wiping out main streets wealth for wall streets in current regime? I have better things to do with the almost $1000 a month I send to CELTIC. You do understand insurance is a parasitic industry right? Produces nothing. I'd rather have my parasites making GS-9 to GS-13 salaries than 1-50M a year.

PS this is one reason why EU and Japan can insure all for half or less than half per capita.

Japan is a TERRIBLE example. Its not just apples and oranges, its apples and elephants. You see, their system couldnt constitutionally exist in this country. First, for profit health clinics and hospitals do not exist. They are against the law. Second, fees for personal health services are set by the government. Thats just for starters.

 

[shira]

To tell you the truth, I would prefer an improved version of Medicare being available to everyone, but we would need to pass tort reform first to reign in the lawyers to keep costs down. But, I would have a hard time reconciling either of those things with the constitution if implemented at the federal level.

Why is there this delusion that tort reform is a major contributor to health care costs? It's a TINY factor. In fact, during the long health care debate, the CBO estimated the savings that would result if tort reform were implemented: 0.5% of health costs (and it's been argued that that estimate is overly optimistic).

 

[nonlnear]

Why is there this delusion that tort reform is a major contributor to health care costs? It's a TINY factor. In fact, during the long health care debate, the CBO estimated the savings that would result if tort reform were implemented: 0.5% of health costs (and it's been argued that that estimate is overly optimistic).

It's one of the more annoying GOP talking points on health care, that's for sure. So many of their other ideas have solid merit it's frustrating that they give the tort reform one such top billing. Ending tax discrimination against non-employer provided plans, and interstate competition would do so much more than tort reform, but the one I hear most often out of them when they want to crap out a sound bite is [parrot voice]tort reform[/voice].

And neither party has made an effective policy or talking point out of ending provider/payer price discrimination - which is a bigger problem yet.

The stress on tort reform probably has more to do with the fact that it would reduce funding to a powerful lobbying group that the GOP often opposes. You think perhaps?...

 

[IronWing]

I had to tell a patient recently (in as kind a way as I could) that because Medicaid changed the numbers on his card before mailing them that he could not get his medication.

This man is now dead. Oh, he may still be walking I don't know, but he's dead. Nothing can save him from the startling aggressive case of AIDS he suffers from other than continued treatment on a timely basis. Now it's too late.

I can say that telling a patient that they are going to die because of a regulatory error didn't sit well with me. He's not the only one affected.

In this case he suffered from a loss of life due to government control and irresponsibility.

That's why I insisted on insurance reform being well thought out in advance.

The government has the ultimate say in whether you live or die based on how well they write words. No other entity has that power, and unfortunately they often do not seem to care that what they do has consequences outside of their intended effort.

Yes, a Swiss type program might be good, but we have a greedy corrupt political system rivaled by few in the First World.

When politicians care about the citizens more than their party, I'll be less apprehensive.

I don't want to hand out another death sentence.

Okay, so what was the exact path between a Medicaid error and this patient's death? You say he could not get the medication he needed. Why? Would the pharmacy simply not provide it under any circumstances? Was it an issue of cost? Did the pharmacist tell the patient "Sorry, wrong number, you die"?

Also, how many private insurance companies provide coverage to AIDS patients and at what cost? Under a single payer system, we wouldn't be having this discussion, the patient would be covered.

 

[Hayabusa Rider]

Okay, so what was the exact path between a Medicaid error and this patient's death? You say he could not get the medication he needed. Why? Would the pharmacy simply not provide it under any circumstances? Was it an issue of cost? Did the pharmacist tell the patient "Sorry, wrong number, you die"?

Also, how many private insurance companies provide coverage to AIDS patients and at what cost? Under a single payer system, we wouldn't be having this discussion, the patient would be covered.

Patient has Medicaid

Patient has AIDS

Government (the same people who would institute a single payer system) institutes a policy where the patient needs to show their card before services can be provided.

Policy was enacted before all the cards were sent out.

Patient comes for his meds.

Coverage was denied.

Pharmacy calls Medicaid.

Medicaid says that they won't give the pharmacy or patient the new number.

Pharmacist explains that the patient will die without his medicine.

Medicaid says that's not their problem.

Medicaid further says that if we were to be able to guess the new number and bill, the pharmacist would be guilty of criminal fraud.

Patient is out of luck because we don't have 4 or 5k a month for him in addition to everyone else who either lost their card or didn't have the new one yet.

I had to tell the patient all this.

Called Albany. No response.

Called the Governor's office. No response.


That was a few weeks ago and he still doesn't have his meds because some bureaucrat didn't think of the consequences of his actions and were in no hurry to fix the problem.


I think that sums up the chain of events.

 

[Hayabusa Rider]

Oh, and the patient HAS COVERAGE, but because of the intractability of the bureaucracy (which single payer is not proof against) he's dead meat.

 

[nonlnear]

Also, how many private insurance companies provide coverage to AIDS patients and at what cost? Under a single payer system, we wouldn't be having this discussion, the patient would be covered.

Patient has Medicaid

Patient has AIDS

Government (the same people who would institute a single payer system) institutes a policy where the patient needs to show their card before services can be provided.

Policy was enacted before all the cards were sent out.

Patient comes for his meds.

Coverage was denied.

Pharmacy calls Medicaid.

Medicaid says that they won't give the pharmacy or patient the new number.

Pharmacist explains that the patient will die without his medicine.

Medicaid says that's not their problem.

Medicaid further says that if we were to be able to guess the new number and bill, the pharmacist would be guilty of criminal fraud.

Patient is out of luck because we don't have 4 or 5k a month for him in addition to everyone else who either lost their card or didn't have the new one yet.

I had to tell the patient all this.

Called Albany. No response.

Called the Governor's office. No response.


That was a few weeks ago and he still doesn't have his meds because some bureaucrat didn't think of the consequences of his actions and were in no hurry to fix the problem.


I think that sums up the chain of events.

But... IronWing said this could never happen with a single payer system. Facts have no power against talking points. Bow to the power of IronWing's talking points!

To be fair, I guess IronWing only said we wouldn't be having this discussion under a single payer system. Parsing that verbatim, it could be true with enough curtailing of speech. Perhaps a central government authority to produce the conversations for the nation would be in order...

 

[IronWing]

Patient has Medicaid

Patient has AIDS

Government (the same people who would institute a single payer system) institutes a policy where the patient needs to show their card before services can be provided.

Policy was enacted before all the cards were sent out.

Patient comes for his meds.

Coverage was denied.

Pharmacy calls Medicaid.

Medicaid says that they won't give the pharmacy or patient the new number.

Pharmacist explains that the patient will die without his medicine.

Medicaid says that's not their problem.

Medicaid further says that if we were to be able to guess the new number and bill, the pharmacist would be guilty of criminal fraud.

Patient is out of luck because we don't have 4 or 5k a month for him in addition to everyone else who either lost their card or didn't have the new one yet.

I had to tell the patient all this.

Called Albany. No response.

Called the Governor's office. No response.


That was a few weeks ago and he still doesn't have his meds because some bureaucrat didn't think of the consequences of his actions and were in no hurry to fix the problem.


I think that sums up the chain of events.

So pharmacy did say "wrong number, you die". Thank you.

 

[Hayabusa Rider]

So pharmacy did say "wrong number, you die". Thank you.

No the pharmacy passed that message along from those who you adore.

 

[nonlnear]

No the pharmacy passed that message along from those who you adore.

That is true. However strictly speaking the pharmacist (you I presume) did have a choice to give the medicine anyways. Both Medicaid and the pharmacist both chose to allow the death.

However that makes the pharmacist no more culpable for the death than every other person on the street who failed to pay for the medicine out of their own pocket too. The party with the moral obligation to provide the coverage (Medicaid) failed to do so and thus they must take the moral heat for it. Unless of course IronWing is blind...

 

[Hayabusa Rider]

That is true. However strictly speaking the pharmacist (you I presume) did have a choice to give the medicine anyways.

However that makes the pharmacist no more culpable for the death than every other person on the street who failed to pay for the medicine out of their own pocket too. The party with the moral obligation to provide the coverage (Medicaid) failed to do so and thus they must take the moral heat for it. Unless of course IronWing is blind...

I could have given it to him and lost my job for handing it out yes, at which point he'd get a month more of life at most.

I could have become a criminal for guessing at the number until I got it right, yes.

I could have broken into Ironwing's home, beaten him to death and stole his stuff to pay for this guy's meds.

Of the three, the last seems most appealing

 

[nonlnear]

I could have given it to him and lost my job for handing it out yes, at which point he'd get a month more of life at most.

I could have become a criminal for guessing at the number until I got it right, yes.

I could have broken into Ironwing's home, beaten him to death and stole his stuff to pay for this guy's meds.

Of the three, the last seems most appealing

I hope it was already clear, but let me put it out there directly: I am not faulting you for your choice. I think you made a respectable decision, even if it did cost a life. After all it could very reasonably be argued that by keeping your job you can help save many more lives. That said I think it's important to be honest about the fact that you did have a choice.

 

[Hayabusa Rider]

I hope it was already clear, but let me put it out there directly: I am not faulting you for your choice. I think you made a respectable decision, even if it did cost a life. After all it could very reasonably be argued that by keeping your job you can help save many more lives. That said I think it's important to be honest about the fact that you did have a choice.

No I understand, but as you might imagine it's difficult for me to dismiss such a thing so casually as IronWing does, and my last was a poor attempt at humor. It's how I deal.

I wonder how many other people this has happened to, and the curious fact that this has been completely ignored. I suppose that it will take a few deaths to be noticed by someone then the backpedaling will commence. At that point people like IronWing will do as he already has and try to find someone to blame other than those who made the policy.

This is how it works here.

 

[rudder]

1) School systems. We all pay taxes for public schools no matter where we live in America. Yet there are still private schools out there. So why would anyone already "paying" for schooling for their children would pay more for private schooling? This is the argument right now being used by opponents of the single payer system. That since people are already paying the government for one thing, they wouldn't use something offered in the private sector.

2) Postal service. We all currently pay for the postal system of USPS. Still, there are private companies like Fedex, UPS, DHL, and many others that are doing well. So why is anyone bothering with using the private companies for their postal needs?


There are many other examples out there like this. Where people all pay for a basic service through taxes, yet there are still private companies competing against the government and still doing well. However, we all have a fall back incase we need it. Single payer would not kill health insurance companies at all.

1) With school vouchers you would see a boom in private schools. My children attend public schools, if I would have a $4000 voucher (amount state spends per year on my child) for tuition at a private school, I would send them there. The people who send their children to private schools know they are not bound to antiquated state standards and offer a better educational experience. If a private school was crappier than a public school, it would go out of business. I cannot afford the taxes and pay tuition to have my 3 children attend a private school. If we had the choice through the voucher system you would see the public school system laying off teachers and closing schools.

2) UPS and Fedex do not compete with the post office. Fedex and UPS developed a service and the post office felt the need to compete with them. The government should be only involved in things private industry cannot accomplish. Private industry does fine with overnight and expedited shipping. Fedex and UPS are very efficient at delivering these packages. For some reason the post office thought they could do the same thing. I use the private companies because I can track my package from the moment it leaves its source. USPS exists so people in outermongoliaville can stay connected. If the USPS were run like a real business, you would be paying $2 to send that 2oz letter to Aunt Mimi. Fedex and UPS would probably be able to offer more, but now they are competing with a USPS that does not have to operate under the same business rules. How long would the post office last if people had to pay $2 to mail a letter?

 

[HumblePie]

1) With school vouchers you would see a boom in private schools. My children attend public schools, if I would have a $4000 voucher (amount state spends per year on my child) for tuition at a private school, I would send them there. The people who send their children to private schools know they are not bound to antiquated state standards and offer a better educational experience. If a private school was crappier than a public school, it would go out of business. I cannot afford the taxes and pay tuition to have my 3 children attend a private school. If we had the choice through the voucher system you would see the public school system laying off teachers and closing schools.

As far private schools being better or going under... I'll debate that to the bitter end. Quite a few of the private schools I know are no better and are in fact worse for actual education than the public schools. So how do they stay afloat? They offer things that public schools don't. Such as being mostly white, or mostly catholic, or mostly some other demographic the parents want their kids to be apart of. That or they want smaller classroom sizes, or some other factor. I can google more than a few studies that point to the academic results of various schools and private doesn't always outrank public. Especially here in Texas with regards to the various state level tests like TAAS. Also, this is consistent results year after year.

Private schools survive because they offer something "different" to public schools for parents. Be it something as simple as uniforms, to sometimes better education, to usually a different demographic alternative; these are all reasons they stay afloat and not just because of actual teaching.


To answer Hayabusa's question about my friend. I'm not sure of all the details. It was awhile ago and I didn't exactly grill the guy. I do know he had a son that had a lot of mental problems so I am guessing that the insurance company decided that he and his family had "costed them enough" if I was to wager a guess.

There is another person I know in a similar circumstance. Friend in OK with MS who is having problems and fighting to retain his insurance in court right now. At least he is living long enough to do so.

 

[rudder]

As far private schools being better or going under... I'll debate that to the bitter end. Quite a few of the private schools I know are no better and are in fact worse for actual education than the public schools. So how do they stay afloat? .

Really it is going to depend on State laws, school funding, etc. In Tennessee (2007) public school students averaged a 20.3 composite ACT score versus 21.85 for private school students. We have some really crappy school districts and some very good ones.

At least near where I live the private schools do outperform public schools.

 

[ShawnD1]

Really it is going to depend on State laws, school funding, etc. In Tennessee (2007) public school students averaged a 20.3 composite ACT score versus 21.85 for private school students. We have some really crappy school districts and some very good ones.

At least near where I live the private schools do outperform public schools.

Are the private schools better or are the parents better? Forking over $5k per year or whatever a private school costs shows that the parents probably care about what grades their kids get. Get at least a B+ or I beat the fuck out of you with my belt. After accounting for that factor of it, 20.2 and 21.85 are pretty close