Medicare for All!

[Ben]

Bernie is pushing "Free medical for everyone!" again (in concert with the Bronx commie). A couple of interesting notes in the link: Sanders claims that the group that came up with the $32.6 trillion price tag (apparently over four years) is run by the evil Koch brothers. When asked what their study showed, the reply was basically, "We haven't done one". A couple of other factoids: Our annual budget is $4 trillion. All the billionaires in the US combined (in case we want to tax them at 90%) are only worth $2.7 trillion.

All that land that's supposed to be converted to pot farming better get converted to moneytree farms instead.

https://twitchy.com/dougp-3137/2018/07/30/team-bernie-disputes-report-about-socialist-utopia-price-tag-and-theres-a-hilarious-catch/

[Pb]

Costs of healthcare in this country is a serious problem.

[TommyGunn]

Costs of healthcare in this country is a serious problem.

Which will never be solved by socialist programs,  or by ignorant political hacks who believe in "free" government programs.

[Pb]

Which will never be solved by socialist programs,  or by ignorant political hacks who believe in "free" government programs.

That's true.  But what were are doing now is a heading for disaster.

[TommyGunn]

That's true.  But what were are doing now is a heading for disaster.

Heading?   I thought we were already there ........

[Firethorn]

Heading?   I thought we were already there ........

Sadly, we have so fubared our medical system that I think that socialist programs, as seen in many countries of Europe and elsewhere, would actually provide better service at lower cost.

The government already picks up the tab for "most" high cost Americans, one way or another.  All "medicare for all" would do is simplify things and help people get treatment sooner - before it is really expensive because they got sick, couldn't afford help, got sicker, ended up broke, THEN having their broke asses covered by medicare and medicaid when they were well and truly fubared, rather than getting medical help back at step 1 that would have kept them working and such.

[De Selby]

Which will never be solved by socialist programs,  or by ignorant political hacks who believe in "free" government programs.

I guess the lessons every other developed country in the world have learned about healthcare don’t add up to much

[Boomhauer]

When you have people that will call the ambulance for extremely minor injuries, go to the ER for minor colds, etc because they have the freeloader insurance, it doesn’t work.

When the current .gov healthcare system known as the VA provides shitty care for a small portion of the population it doesn’t work

When various levels of  administrators siphons off  large amounts of funding before it ever hits the hospital floor it doesn’t work

But hey let’s go ahead and implement it fully I’m sure it’ll work out just fine 

[Ben]

At the risk of contradicting my OP and sounding like a commie, I am actually open to any and all possible alternatives to me paying $8400 a year for a physical. I just don't believe "medicare for all" is the answer.

Even, if for the sake of argument, we agreed that country "X" had an excellent government run health care program, and we wanted to emulate it, what would the chances be of the US effectively implementing it? I pessimistically predict it would turn into some Frankenstein's monster of that "ideal". Mostly because our basically binary political system would have politicians on both sides of the aisle fighting each other. We'd end up with few positives of the program and many negatives. Our politicians wouldn't look at getting things in that are positive to their base, they would look at getting things in that are negative to the other side's base.

Also much of what Boomhauer said above. People calling the ambulance because they sneezed is a big problem. It's brought up locally here all the time, because people do that to circumvent the three hour wait in the emergency room (filled with an 80% population of non-emergencies). I don't believe "free" government insurance would end that. It's a cultural problem. In fact, I believe it would increase if everyone was guaranteed a free ambulance ride to cutting in front of the line and getting immediate health care.

I don't know what the answer is. I just know that I used to have great, cheap insurance. Then the government got involved with ACA and it all went to *expletive deleted*it.

[TommyGunn]

I guess the lessons every other developed country in the world have learned about healthcare don’t add up to much

My parents lived in Scotland in the mid 1980s and from their experience,  and those of their Scottish friends,  I wouldn't wish the British system on an enemy.  Unless it was for the common headcold.

A couple wannabe Kongresskritters now want "medicare for all".  Estimates indicate it would cost 3 trillion dollars annually to do that.  America's yearly budget is 4 trillion,  and the country now has a > $20 trillion national debt.  
So, sure,  we can easily afford the government to go full socialist on us.  Easy-peasy.

Maybe the Aussies have managed utopia .... but those kangaroos kick nasty!

[mellestad]

Honestly, I'm for single payer healthcare. We haven't had a real private system in ages--the current insurance regime is just as big, more complicated, more corrupt, just as expensive, and has less oversight than what a government run program would be. And that's saying a lot because I have almost zero faith in the government to do anything right.

Fact: There will never be true private healthcare in America again. Ever.
Fact: The system we have now has us paying more than equivalent societies for no greater benefit.
Fact: Healthcare costs are spiraling even more out of control.
Fact: Perfect is the enemy of good.
Fact: If you're not middle-class or above the current system will destroy you if you have a serious illness.

I'm ready to be done with the whole thing and replace the private insurance monopolies with a government run monopoly. It will suck. It will not be optimal. There will be terrible, awful compromises. There will be corruption. There will be poor spending choices. There will be people who literally die because of decisions made at a high level.

But all those things already happen, and you're totally powerless to do anything about it unless you have a good income and you're educated/patient/mentally capable of navigating the private insurance labyrinth.

I say all of the above as someone with great insurance and a very comfortable income.

[Ben]

Fact: There will never be true private healthcare in America again. Ever.

Truth. I honestly don't see true free market and private insurance ever coming back. We will at some point end up with gov run insurance. I guess it will just be between being sorta screwed or royally screwed, depending on what is implemented.

[Firethorn]

A couple wannabe Kongresskritters now want "medicare for all".  Estimates indicate it would cost 3 trillion dollars annually to do that.  America's yearly budget is 4 trillion,  and the country now has a > $20 trillion national debt.  
So, sure,  we can easily afford the government to go full socialist on us.  Easy-peasy.

And about a trillion less than what we pay for healthcare NOW.  So you'd be trading your current healthcare spending(on average, mind you) for a smaller tax increase.  Bernie isn't very good at expressing that part though.

And yes, we'd still be able to charge for ambulance rides.

I'm with mellestad here.

[makattak]

And about a trillion less than what we pay for healthcare NOW.  So you'd be trading your current healthcare spending(on average, mind you) for a smaller tax increase.  Bernie isn't very good at expressing that part though.

And yes, we'd still be able to charge for ambulance rides.

I'm with mellestad here.

What color is the sky in your world?

In this Universe, just how is the Federal Government going to efficiently (at $1,000,000,000,000 LESS!!!!) run the healthcare system of the United States?

Don't tell me "well, other countries do it!" or "just like Medicare!"

Our government bureaucracies, especially federal, are VASTLY more inefficient than the private sector and also that the other countries' bureacracies that you are planning to use as your model. We'll end up with the STELLAR care that is provided through the VA. THAT is the model you need to look at as to how OUR government would run healthcare.

[MechAg94]

What color is the sky in your world?

In this Universe, just how is the Federal Government going to efficiently (at $1,000,000,000,000 LESS!!!!) run the healthcare system of the United States?

Don't tell me "well, other countries do it!" or "just like Medicare!"

Our government bureaucracies, especially federal, are VASTLY more inefficient than the private sector and also that the other countries' bureacracies that you are planning to use as your model. We'll end up with the STELLAR care that is provided through the VA. THAT is the model you need to look at as to how OUR government would run healthcare.

I gotta agree with this.  I think the cost estimates reported are wishful thinking.  They only way that would be accomplished is through rationing and telling people no.  And you can guarantee the people who should be refused service will get service.  The people who legitimately need service, will get refused. 

The only way out of this the problem is to get the Govt out of it.  I doubt that will happen also, but it is the only thing that will work.  A portion of the public will never like a free market approach because the freeloaders always have sob stories about how they can't afford stuff and some people believe them.

[brimic]

That whole economics thing...
Unlimited needs and limited resources...
The whole premise that big daddy government can take care of everyone's medical needs with a finite level of medical services (or money or manpower) is asinine.
It can only lead to cuts and outright elimination to expensive, yet critical procedures.... got cancer, need an organ transplant, need a joint replacement, need back sugery, have a premature baby? Tough luck buttercup.
It will be a net benefit to everyone who doesn't produce anything or contribute to society, at least at first, but it will lead to a severe decline in health care for everyone (except the really important or wealthy people- they always get an escape hatch). 

[mellestad]

About the government being less efficient--I think the disconnect here is that anyone thinks what we have now is "private". Blue Cross, etc. is in no way a "private" company anymore. The whole insurance system is so regulated, conglomerated, backwards, hostile, bloated, greedy, secretive, and generally messed up that it's more inefficient than a government run system would be--all we've done is make fifty competing government entities that sell us healthcare.

What we have now is totally screwed. If I'm going to be shafted, I'd rather be screwed by something I can at least vote on and have it get kind of cleaned up every 20 years when a somewhat more sane administration gets into power.

Put another way--fighting with medicare is, in my experience, actually easier than fighting with my insurance carrier. That ISN'T a complement to Medicare--just a commentary on the sad state of affairs all around.

Another argument is that, if we assume single-payer is less efficient (arguable, I'd say, for reasons above) at least the original mandate of the agency would be to help people, not fleece them. That means you can afford to lose some efficiency anyway because you just have to break even, not generate profit increases every quarter.

[brimic]

Because of Medicare and HMO regulations, its the people who are privately insured that are picking up the tab for government underpayment of services.
.Gov regulations have added a MASSIVE amount of administrative overhead to health care, and none of it is free.

There is a small movement of private practice Drs who don't take medicare nor insurance, who are able to provide services for what seem to be almost absurdly low prices (at least compared the norm).

Remove government from the equation and reign in trial lawyers, and you will see the cost of medicine drop dramatically.

[mellestad]

You know how people love to give the military crap for being inefficient? 50k toilet seats, hahaha?

OK, you know what I can get for a million bucks in the US Army?

Five fully equipped up-armored Humvees.
or
A nice APC and some change left over.
or
Battle-ready kit for fifty infantrymen.
or
70% of a Tomahawk cruise missile.

You know what I can get for a million bucks from our "private" insurance system?

One course of cancer treatment.
and
I still lose my home.

[Ben]

Because of Medicare and HMO regulations, its the people who are privately insured that are picking up the tab for government underpayment of services.
.Gov regulations have added a MASSIVE amount of administrative overhead to health care, and none of it is free.

This would be my totally selfish reason for being okay with gov healthcare if it happened. Since they'd force most middel income and higher people to pay higher taxes, distributing that cost would lower my current annual insurance costs. Being privately insured, I'm paying for me and probably a couple of other people who are getting stuff at reduced cost via ACA, or free via obamacare.

Likely taxes would have me paying for me and maybe another 1/4 person, since everyone, including those under employer provided healthcare, would be paying part of that burden.

Again, from the "selfish" perspective, not necessarily the "right" perspective.

[brimic]

You know how people love to give the military crap for being inefficient? 50k toilet seats, hahaha?

OK, you know what I can get for a million bucks in the US Army?

Five fully equipped up-armored Humvees.
or
A nice APC and some change left over.
or
Battle-ready kit for fifty infantrymen.
or
70% of a Tomahawk cruise missile.

You know what I can get for a million bucks from our "private" insurance system?

One course of cancer treatment.
and
I still lose my home.

I don't think you quite understand how insurance works.... just saying.

[RoadKingLarry]

Once .gov controls healthcare and takes the needed steps to control cost by limiting the pay of medical professionals how many doctors will voluntarily stay in the system?
Today the costs are out of control because a good specialist can pretty well make a fortune charging all the market will bear.
The billing statements from my recent hip replacement are pretty astronomical.
My "insurance" pays 90% of costs, except when they don't. I think I've gotten all the bills by now and I'm out of pocket close to $8K. Which I'm still trying to reconcile with my $5K out of pocket maximums.
I don't know.what the solution is but if the answer is "more government" the wrong question was asked.

[Hawkmoon]

Once .gov controls healthcare and takes the needed steps to control cost by limiting the pay of medical professionals how many doctors will voluntarily stay in the system?
Today the costs are out of control because a good specialist can pretty well make a fortune charging all the market will bear.
The billing statements from my recent hip replacement are pretty astronomical.
My "insurance" pays 90% of costs, except when they don't. I think I've gotten all the bills by now and I'm out of pocket close to $8K. Which I'm still trying to reconcile with my $5K out of pocket maximums.
I don't know.what the solution is but if the answer is "more government" the wrong question was asked.

Larry makes a good point.

I'm a Vietnam veteran and I get much of my health care through the VA. Some of you are probably aware that the VA has been under fire for excessively long wait times for appointments at VA facilities, so they came up with a program called (IIRC) "Veterans Choice." Under this program, if you can't get an appointment at the VA within (I think) 30 days, you can choose to have them authorize you to go to an outside doctor, and the VA pays for it.

I had an introduction to how that works recently. In December of 2017 I had a bunch of open sores on my lower legs. I called the dermatology department for an appointment, and they told me they didn't have any openings until late February. I needed help right then, so the person in dermatology told me I could go with Veterans Choice, and he gave me a number to call.

It took me a full week of exchanging voicemail messages before I was actually able to talk to someone at the Veterans Choice number. When I finally spoke with a live person, she told me that I was NOT eligible for Veterans Choice because my records at the VA hospital didn't indicate that I had been referred to the Veterans Choice program. I told her that I had most certainly been referred, that it was the dermatology department that gave me the number to call. Her view was that this wasn't a "referral." Apparently, to get a referral over not being able to get an appointment in a timely manner I would first have to get an appointment, and then have the doctor refer me to the Veterans Choice program.

But we're not done yet. I had the personal e-mail of the chief attending doctor in the dermatology department, from a complaint I had filed several years before involving one of their residents. So I e-mailed the doctor, and he brought me in and treated me personally more or less on the sly. It's all in the records, but it wasn't a normal appointment. I came when he was on the floor, and he saw me between consultations with scheduled patients. I mentioned my debacle with Veterans Choice, and he laughed. He said the program was a joke anyway. According to him, at least for dermatology nobody can get an appointment through the Veterans Choice program, because all the private dermatologists are booked solid and they aren't taking new patients. He said IF you could get an appointment, it would be three to six months in the future -- which, of course, obviates the whole point of the program.

And I'm next door to a city with a teaching hospital, so it's not like we have any shortage of physicians in the area. It must be many times worse in regions that don't have large, teaching hospitals to draw doctors from. Most of the residents at the VA hospital are drawn from the medical school. The dermatology doctor I saw is on the faculty there.

[MechAg94]

About the government being less efficient--I think the disconnect here is that anyone thinks what we have now is "private". Blue Cross, etc. is in no way a "private" company anymore. The whole insurance system is so regulated, conglomerated, backwards, hostile, bloated, greedy, secretive, and generally messed up that it's more inefficient than a government run system would be--all we've done is make fifty competing government entities that sell us healthcare.

What we have now is totally screwed. If I'm going to be shafted, I'd rather be screwed by something I can at least vote on and have it get kind of cleaned up every 20 years when a somewhat more sane administration gets into power.

Put another way--fighting with medicare is, in my experience, actually easier than fighting with my insurance carrier. That ISN'T a complement to Medicare--just a commentary on the sad state of affairs all around.

Another argument is that, if we assume single-payer is less efficient (arguable, I'd say, for reasons above) at least the original mandate of the agency would be to help people, not fleece them. That means you can afford to lose some efficiency anyway because you just have to break even, not generate profit increases every quarter.

Is anyone here under the impression the current system is free market?  I didn't think so.

[RocketMan]

About the government being less efficient--I think the disconnect here is that anyone thinks what we have now is "private". Blue Cross, etc. is in no way a "private" company anymore. The whole insurance system is so regulated, conglomerated, backwards, hostile, bloated, greedy, secretive, and generally messed up that it's more inefficient than a government run system would be--all we've done is make fifty competing government entities that sell us healthcare.

All of what you said above is true, except the last italicized part.  The reason our health care and health insurance system is so fubar is due directly to government interference.  And the most egregious damage was done in the last ten years, a direct result of ObamaCare.
Thinking that government run health care (read: socialized medicine) would be more efficient is shows a hopeless naivete.
All of that said, I believe socialized medicine is where we are headed.  It wouldn't surprise me if a Republican administration has a large hand in its implementation.  I wish the idiots in kongress would just get it over with.