OT The Progressive march to National Healthcare

True, but they're kind of related, you know. All those actuaries crunching numbers for the insurance companies are trying to estimate costs of what they'll have to pay out vs. the insurance premiums they charge for the plans.

 

My tushie is primo ala-naturale. No need to mess with perfection.

 

Your Senator is paid $174,000 with per diem and travel and office expenses. He lives among enough lobbyist that he forgot where his wallet is. He exempted himself from the shit plan he voted to give you.

You use the word tradeoff, what does it mean?

 

Geez, that needs to be said more often. More to the point, just because you have insurance, does not mean you can get healthcare.

 

Insurance companies have to price their plans to turn a profit--they're not in it just to provide a non-profit service, like the government can. Further, while government programs can certainly generate waste when poorly designed or implemented, a single system has at least the opportunity to trim a lot of fat that exists in the existing system where every insurance company has to have their own infrastructure (like, actuaries), the operating costs of which need to be passed on to the consumer. Obviously, a Medicare-for-all would need plenty of infrastructure, but with a lot less duplication since it'd be a single entity. It would also probably be a lot less complex to figure out costs when the entire nation is a single pool, as opposed to each insurance company creating their own risk pools and trying to figure out how to price each pool.

I could imagine Medicare for everyone not necessarily working out great (again, design and implementation matters), but there is plenty of opportunity for it to reduce costs while still allowing people to get all important treatment covered (including preventative care which tends to reduce costs overall by reducing the number of people who end up with serious problems). We could even learn from what other countries, who have done universal health care, found to work, like charging extremely minimal co-pays (like $5-10) because attaching any monetary cost to something (even such small ones) tends to reduce frivolous visits while not deterring people who actually need a doctor's visit.

 

I'm pretty ambivalent about Medicare as a single-payer system for everyone. From a personal standpoint, I'll be 65 in the fall so that's what I'll be on regardless of what may end up being done with healthcare at large. Government generally has inherent bureaucratic issues that result in waste and needless regulations and rules, but overall, Medicare seems to work pretty well. The biggest issue seems to be that many doctors won't take Medicare patients because the compensation rates are lower than market rates, but if it were the only game in town, I'd think that would resolve itself. I'd certainly favor a single-payer system over the Obamacare exchange mess or any of the Republican "fixes" that have been proposed so far. I think the biggest problem is the difficulty in selling it to both ends of the political spectrum. Those who have obtained better plans through collective bargaining aren't going to want to lose their benefits. Those who dislike government programs, especially entitlement programs, are never going to be on board. Those who will foot the bill are going to fight it tooth and nail. The medical industry and its lobbyists are going to oppose anything that might end up hitting their profit margins. And all of that is pretty much why we have the mess that we have now and why it's going to be nearly impossible to change it.

 

Well, I disagree that we have a "mess" right now, though I certainly agree with your reasoning for why changing the health care system is so difficult. There are so many interest groups and most people are risk-averse--their fear of losing what they have far outweighs their interest in what upside there might be to change.

I think the compensation rates are lower because it's hard to fund Medicare. It's a popular program but the Republican party will in general fight any further money going into an entitlement program. That's definitely an issue and would make creating a workable universal Medicare program tough--even the greatest program in the world (leaving aside whether universal Medicare is that) won't work without sufficient funding.

I was more discussing why such a system has an upside, rather than how politically viable it is. I think it's more viable today than it was 8 years ago, because Obamacare (for good or ill, depending on which side of the divide you're on) has shifted the Overton window on health care. As Republicans are finding now, a plurality of Americans now feel that access to health care is something that the government should be providing, or assisting in, which wasn't the case pre-Obamacare. The implication of that is that it's no longer politically plausible to abandon government's role in health care--the debate from now on will concern the shape of that role. I think we're probably a number of years from single-payer, but I could imagine a public option being added to the current system the next time health care is meaningfully tackled.

 

Maybe not. But both of them voted to give us this shit and then voted to exempted themselves.

 

Now it looks like the Republicans are going to make another run at repealing Obama care. I guess they don't like the feel of defeat.
But geez! They still don't know shit from Shinola! They still plan to force a number of things on insurance companies to get the maximum number of people covered.

I am totally against this government intrusion into this industry. This product offered to the people as a result of government interference is not insurance which would stand on it's own
as a product worthy of consideration to help mitigate a persons financial risk of usual medical costs. What we end up with is a product of higher cost by forcing the insurance to company to accept the known risk of preexisting conditions and even high risk lifestyles. The insurance companies should be left to market a product to people and let them make the choice whether it is useful or not.

If the people have the will to cover that segment of the population that does not get healthcare via their work place and can not purchase insurance or pay for their healthcare, then perhaps Medicare/Medicaid should be expanded in some manner. However, the administration of government run programs must cease to be managed to underpay the providers and force them to shift the costs of this large segment of society to the younger working population covered by insurance they purchase or their employers. The youth of this nation and small businesses must not be forced to bear the cost of caring for this potential large segment of the population. It is totally unfair, and in the end, does not really save the government money. It wasn't all that long ago, I can recall buying a healthcare policy for a young fellow of 23 for $130 a year. A fair price for a product that was unlikely to be used. Not available today.

The Republicans need to understand, make a free market solution, a government solution, or both but not the pollution of commingling both.

For those that respond immediately that Government role is to regulate the industry. I agree. But regulation is separate from, defining the content of the product and forcing, or coercing any person to buy the product.

I suspect I will lose, and you will too. But I must say, I do not think this issue really should be divided down party lines or ideologically. There is a logical solution that contains enough feeling to adequately meet the needs, IF one recognized the common need.

 

The net of it is, we need the Republicans and the Democrats to get it done. We need the Republicans to do the restore the system with a free market insurance program again and the Democrats to bring in a properly designed government run program. Neither party can do this alone. Neither party has both the head for the complete task, nor the heart for both.

 

What I have said above is really only talking about insurance. Which is not the only way to pay for health care. The larger employers are mostly self insured, that is they have enough employees to cover, where it is more economical to cover the risks themselves and endure the cost directly. Saving the cost of management fees and profit taken if they had involved insurance companies. Some do not do it alone, they partner with other companies to expand the risk pool and share the cost and risk.

Such a scheme could be made more available to small business and even individuals. The Farmers have health insurance available in some areas like this, as do Unions. No reason out all, it can not be expanded and more available. Some people, especially the young singles, Health Savings accounts can be used to pay for health care directly with catastrophic insurance to back them up. It makes much more sense than the horrendously costly insurance the Obama Care plan stuffed the young people with currently. The fines for not buying in, are not short at all of being cruel, if not criminal. That is a Tax, a direct Tax.

 

yep.....that's part of it....72 injections and 2 weeks to kill that bacteria...I got it from a scratch on my ankle from a motorcycle peg and was snorkeling around a reef that had medical waste garbage strewn throughout it.....it was scary as hell.

 

I guess I should have given you the clue. Cooperative, is what the Farmers call theirs.