Medicare for All!

[De Selby]

Single payer will not result in superior care.

Don’t listen to the leftists, they always confuse their good intentions with good results.

You don’t solve the free rider problem by making everyone free riders.

How ignorant of human nature do you have to be to recommend such a delusional idea?

Single payer is unsustainable like all socialist scams.

Reject being scammed.

So what’s your solution, and where is one example of it working?

[MillCreek]

https://www.nytimes.com/2018/07/22/us/politics/medicare-payments-trump.html

The current Administration has a very Socialist proposal: pay a flat rate for a Medicare office visit, regardless if it is for a rash or lung cancer.  If it goes through, specialists will not be enthused to see Medicare patients.

[Ron]

So what’s your solution, and where is one example of it working?

The only real solution is to double down and let it fail catastrophically.

Let the Leftists give us the British system (while .gov exempts themselves from the restrictions).

Give the people what they want, good and hard.

[Fly320s]

So what’s your solution, and where is one example of it working?

Each person is responsible for himself.  He has to provide for his own medical care and can not make others do it for him.

Works everywhere, because free-market.

[MechAg94]

Each person is responsible for himself.  He has to provide for his own medical care and can not make others do it for him.

Works everywhere, because free-market.

Agreed.  It almost always ends up being the system with the most efficient use of resources.  And with the enormous amount of charitable giving in this country, there will be a lot of groups helping those who cannot afford the more expensive treatments.  Also, providers and pharmaceutical companies will have to rethink how they are selling and charging for their products/services (compared to now). 

[Ron]

Each person is responsible for himself.  He has to provide for his own medical care and can not make others do it for him.

Works everywhere, because free-market.

But then we can’t feel good about helping “everyone”.

“We” have to do something via the federal government because we can’t leave people to their own devices.

Even if it doesn’t work at least we had good intentions.

I want to feel good.

[RoadKingLarry]

But then we can’t feel good about helping “everyone”.

Even if it doesn’t work at least we had good intentions.

I want to feel good.

Drink some beer

[Scout26]

A long time ago we used to have these things called "Mutual Aid Societies".  Most were church or religion based.  They helped when people were unemployed, sick/hurt or when a member passed away.  Usually you paid into each month whatever you could afford so that you had a combination of life, medical, and disability insurance.

I'm not sure why something like that couldn't work again.

[JN01]

A long time ago we used to have these things called "Mutual Aid Societies".  Most were church or religion based.  They helped when people were unemployed, sick/hurt or when a member passed away.  Usually you paid into each month whatever you could afford so that you had a combination of life, medical, and disability insurance.

I'm not sure why something like that couldn't work again.

There is Medishare for medical issues: https://www.medishare.org/ppc/?utm_source=bing&utm_medium=cpc&utm_campaign=&utm_term=medi%20share&mkwid=PLftcsqc_dc&pcrid=73873564851669&pmt=be&pkw=medi%20share&utm_source=bing&utm_medium=cpc&utm_term=medi%20share&utm_campaign=Brand%20-%20MediShare%20-%20New%20Domain%20-%20B&leadsource=Internet-Search%20Engine&custentity_urlreferralid=Brand%20-%20MediShare%20-%20New%20Domain%20-%20B&custentity_urlreferralid=medi%20share&_vsrefdom=Bing-B&intent=Brand-Medishare

[lee n. field]

"Medicare for allz!"    The nomenklatura, of course, get the good stuff.  The rest of us get the doctor's office in the back of the DMV.  Take a number.

[Scout26]

A long time ago we used to have these things called "Mutual Aid Societies".  Most were church or religion based.  They helped when people were unemployed, sick/hurt or when a member passed away.  Usually you paid into each month whatever you could afford so that you had a combination of life, medical, and disability insurance.

I'm not sure why something like that couldn't work again.

Just to go further on that, they also to care of widows, orphans, and the destitute.   

An example near me: http://www.mooseheart.org/history/

[Ben]

A long time ago we used to have these things called "Mutual Aid Societies".  Most were church or religion based.  They helped when people were unemployed, sick/hurt or when a member passed away.  Usually you paid into each month whatever you could afford so that you had a combination of life, medical, and disability insurance.

I'm not sure why something like that couldn't work again.

I have to wonder if some of it is not feasible simply because with today's medical costs, potential bills for serious conditions can vastly outweigh money collected in the pool. Even adjusting for inflation, I'm guessing there was nothing like $10K/day hospital stays, and single surgeries that can cost $200K or more, back when these programs were more popular.

If we could get some of those costs under control, medical pools would possibly have a better chance of working and remaining solvent.

[Fly320s]

Even adjusting for inflation, I'm guessing there was nothing like $10K/day hospital stays, and single surgeries that can cost $200K or more, back when these programs were more popular

You're right, those expensive treatments are a new phenomenon, because the technology didn't exist back then.  If you want the best-in-class medical team to replace your fat-clogged arteries, you're going to pay for it big time. 

The newest and best technology is always the most expensive.

[Ben]

You're right, those expensive treatments are a new phenomenon, because the technology didn't exist back then.  If you want the best-in-class medical team to replace your fat-clogged arteries, you're going to pay for it big time. 

The newest and best technology is always the most expensive.

Certainly that's a data input. If you had fat clogged arteries that needed replacing 100 years ago, you mostly just died. Many of the most expensive procedures today are sophisticated and life saving or life extending.

There are still some ridiculous costs for non-sophisticated procedures though, IMO mostly centered around what medical facilities can get from insurance companies. Not unlike the whole college textbook scam, where students have to buy a $30 book for $100. There are lots of examples, some given by members here, of people making cash deals with doctors that are sometimes 50% of the going rate for insurance covered stuff. Physicals for example.

When I was working and had dental insurance, my dentist always gave me I think 25% off for stuff not covered by the insurance if I would pay for it up front.

[Scout26]

That's another problem.  No one knows what anything in a hospital REALLY costs anymore. Medicare pays at one rate, Medicaid at another (very low) rate, each insurance company has their own deals with each hospital/Medical group.  And since the end consumer/user never really sees a bill, other than for their deductible, they don't know what they were billed for.  How many stories have we've read where where people get the same procedure done (without any follow-on complications) and the costs are completely different (wasn't there a guy in New York, IIRC, that is suing to find out ?) 

I remember when I had surgery when I was twelve and my mom arguing with the hospital billing department about the bill she received and the prices of various things.  This was before the day of assigning benefits and having the hospital bill the insurance company direct.  They billed the patient (or their family) who had to pay first and THEN that person had to submit to the insurance company for re-reimbursement.  Now, you don't get an actual bill, you get a "statement of benefits", from the insurance company, long after everything is done and paid.

[Pb]

I have an idea.  The law should require all hospitals to charge patients exactly the same per service, no matter how they pay.  They must present the costs before treatment, and the patient must agree.  These prices should be placed online where anyone can compare prices.

[Scout26]

I have an idea.  The law should require all hospitals to charge patients exactly the same per service, no matter how they pay.  They must present the costs before treatment, and the patient must agree.  These prices should be placed online where anyone can compare prices.

Yes, We price shop cars, insurance, electronics, everything else, and mostly on-line.  We compared the prices even of Amazon resellers.  We should be able to shop hospitals and doctors.

[Fly320s]

We should be able to shop hospitals and doctors.

Yes.

The law should require all hospitals to charge patients exactly the same per service, no matter how they pay.

No.  Absolutely not.  Do you want the FedGov to prevent companies from negotiating for better prices?

[Scout26]

Yes.

No.  Absolutely not.  Do you want the FedGov to prevent companies from negotiating for better prices?

"Cash Price

Procedure A at Hospital X is $Q

Procedure A at Hospital Y is $R

Contact your insurance company as they may be able to get you a better price"


We as consumers need to knw the costs to make good decisions.  Also competition will go a long toward reducing costs.

[Firethorn]

There are still some ridiculous costs for non-sophisticated procedures though, IMO mostly centered around what medical facilities can get from insurance companies. Not unlike the whole college textbook scam, where students have to buy a $30 book for $100. There are lots of examples, some given by members here, of people making cash deals with doctors that are sometimes 50% of the going rate for insurance covered stuff. Physicals for example.

$30 book for more like $450 these days.  $100 is cheap for a college text these days.

When I was working and had dental insurance, my dentist always gave me I think 25% off for stuff not covered by the insurance if I would pay for it up front.

Indeed.  My brother has gotten discounts of 50% or more in healthcare by negotiating cash up front.  He even developed a list of clinics willing to work for cash.

What really needs to be banned are the insurance deals of "X% below cash price".

The deal that an insurance company strikes with the provider should not affect the deals other customers get.

[Fly320s]

"Cash Price

Procedure A at Hospital X is $Q

Procedure A at Hospital Y is $R

Contact your insurance company as they may be able to get you a better price"


We as consumers need to knw the costs to make good decisions.  Also competition will go a long toward reducing costs.

That is the proper way to do it.  Just leave the government out of it.

[grampster]

Here's a problem with auto insurance to add to the mix.  In Michigan we have NoFault auto insurance with unlimited medical benefits.  Hospitals and doctors charge, and actually have admitted in court, that they bill the auto insurer at 150 to 175% of the actual cost of treatment.  That is because of all the bargaining that has occurred by the Fed and private insurers.  The auto insurance companies wanted a level playing field on uniform charging.  The Judge ruled that is was OK for the medical community to continue to overcharge in order to cover potential losses from the other side.  We have the highest auto insurance rates in America as a result.  We also have a secret organization set up by the state and staffed by auto insurance executives that charge each auto a fee for catastrophic injury claims.  It's called the Michigan Catastrophic Claim Association and the information on how much money is in that pool and how it is paid out is withheld from the public.  Currently it's around $170.00 per car per year.  There is around 3.5 million cars in Michigan.  Do the math and then understand no one can be privy to any the information about where that money goes and how it's spent.  Insurance companies only have to pay up to $250,000 of the unlimited medical coverage and the MCCA kicks in.  Another example of how government interference in stuff causes more trouble than it's worth.

[MechAg94]

The other part that needs change is the requirements for hospitals to care for everyone regardless of ability to pay with legal liability attached.  People should not be able to use the hospital as their free clinic.  Hospitals should be able to give them the minimum care needed to keep them alive another day and then kick them out.  I know a lot of people don't like that idea, but it is a form of welfare handout that needs to change.  There has to be a way to get hospitals out of that cost/liability trap and force people to pay their own way. 

It is difficult to do because Americans are generally compassionate and don't want people to be left without care.  I just think it is a cost we are all paying for via Govt/Taxes that is greatly magnified by the way it is done. 

[lupinus]

The other part that needs change is the requirements for hospitals to care for everyone regardless of ability to pay with legal liability attached.  People should not be able to use the hospital as their free clinic.  Hospitals should be able to give them the minimum care needed to keep them alive another day and then kick them out.  I know a lot of people don't like that idea, but it is a form of welfare handout that needs to change.  There has to be a way to get hospitals out of that cost/liability trap and force people to pay their own way. 

It is difficult to do because Americans are generally compassionate and don't want people to be left without care.  I just think it is a cost we are all paying for via Govt/Taxes that is greatly magnified by the way it is done. 

The unfortunate part of making that point is it is just turned around as one of the benefits of single payer. If everyone is covered by uncle sugar then no one goes to the ER without the hospital getting paid.

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[makattak]

The unfortunate part of making that point is it is just turned around as one of the benefits of single payer. If everyone is covered by uncle sugar then no one goes to the ER without the hospital getting paid.

That's because the people turning it around are morons.

The hospital gets paid, but there are a lot more people going to the ER instead of Urgent Care or a PCP. Real cost "savings" there.