patrick.net

But only for citizens.

Notwithstanding the support of the influential groups for the proposal and ― according to a May 2016 Gallup poll ― even a majority of the American people, Medicare-for-all legislation is a non-starter in the current Congress.

I definitely support the option to allow anyone into Medicare, and so do a majority of Americans, but Congress does not want that.

Because they know who is paying them, and it's not us.

rando says

Because they know who is paying them, and it's not us.

Please! Say it ain't so.

If we're going to have an everyone on Medicare, then I want Fully funded Federal hospitals and dedicate a branch of our military to educating Doctors and other health professionals regardless of socioeconomic background. And dedicate some of the Federally owned property around the country to Federal Hospitals and Clinics.
Private institutions getting paid from the system, should be the most scrutinized transactions in America. Healthcare fraud should be rare, and a guarantee to get caught. Like it is welshing on your taxes.
Nobody gets away with it.
People get away with Medicare fraud because we look the other way, because most of Congress is heavily invested in those companies.

Fuck with the Medicare and you're fucking with the US Army Physician Corps.

Tenpoundbass says

If we're going to have an everyone on Medicare

I was thinking it would be an optional thing. Buy into Medicare if you want to.

rando says

Buy into Medicare if you want to.

Our taxes would pay for Chronic care for all. You would still get bills for Stitches, Borken bones or Doctor visits for infections and quick curable Maladies. But we're talking about $300 to a few thousand dollars bills not 10's of thousands that those things could cost today.
That could be taken out from taxes or paid in full. Those over 62, disabled and hoplessly indigent it is all free.

Ironman says

How soon we forget.

A bit short sighted. Unlike the Rethugs, and captured Demoncrats, Bernie would have allowed Medicare and Medicaid to negotiate drug and device prices, just like private industry does. And how much is Trumpy's military spending going to cost again?

Ironman says

Tenpoundbass says

it is all free.

How soon we forget..

We got an Army that does dick all, they languish and rot. That is why every 20, 30 years the Military industrial complex has to muster up Wars and Follies to justify them. I think it's time we turn the Army Corp of Engineers and Physicians Corps lose on America. You can still pay for private care, it would flourish under this model. It would mean cheaper healthcare private or otherwise. Bernie Sanders and any current budget accounts for our hyper inflated run away economy that has gone unchecked for the last decade. While every Fed Chief lied and said there was no inflation. We need to reel it back in, we can't have wage inflation to match the level of inflation that has happened. Most of the inflation is due to rent seekers owning a cut of every transaction that happens in the world. To much consolidation in everything. Break that shit all up, and reign in untethered corruption a public healthcare system would be doable. I think we had a healthy booming Middle Class and real low unemployment. And taking these people that are considered no longer looking for employment. And make employment available for them. Because we wont be giving them other free shit. Just healthcare. This isn't the full carte blanche Welfare that Democrats always make Healthcare. They will take you and sign you up for every "benefit" known to man. Just because you need help with a medical bill. That's been our healthcare failure. They've been creating welfare cases.

I say put everyone to work cut out the fraud our taxes will pay for cancer treatment, and heart surgery. But you will pay for all of the other medical related stuff a reasonable fee.
If you are paranoid of Government healthcare then you would be free to go Private healthcare. Which the HIPPA laws should protect you from the Government intrusion.

Could be a great system there if people quit playing Cold War, Welfare Queen, Jim Crowe shithouse petty politics.

Do you know Obama literally had 40,000 bastards working in the state department to dream up ways to make shit more unaffordable for everyone, and to make sure people like you and me never work another day in our lives. While promoting racial diversity.

Meet the new boss same as the old boss.

Ironman says

Ya really think so?? Bernie hasn't got shit done in Congress in 20 years...

Hard to get shit done when morons are blocking things.

Senate Republicans Block Trump Proposal to Lower Prescription Drug Prices
Tuesday, December 6, 2016
WASHINGTON, Dec. 6 – Sen. Bernie Sanders (I-Vt.) proposed an amendment Tuesday to lower the cost of prescription drugs by letting Medicare negotiate drug prices and allowing for the importation from other countries of low-cost prescription drugs – both proposals advocated by President-elect Donald Trump.

Republicans blocked the Sanders amendment.

During his run for the White House, Trump called for requiring Medicare to negotiate with drug companies to lower prices. In a speech in New Hampshire last Feb. 7, Trump criticized current U.S. law that forbids Medicare from negotiating prices with pharmaceutical companies. Trump said: “We are not allowed to negotiate drug prices. Can you believe it? We pay about $300 billion more than we are supposed to, than if we negotiated the price. So there’s $300 billion on day one we solve.”

https://www.sanders.senate.gov/newsroom/press-releases/senate-republicans-block-trump-proposal-to-lower-prescription-drug-prices

Bill to Let Medicare Negotiate Drug Prices Is Blocked
WASHINGTON, April 18 — A pillar of the Democratic political program tumbled today when Republicans in the Senate blocked a proposal to allow Medicare to negotiate lower drug prices for millions of older Americans, a practice now forbidden by law.

Democrats could not muster the 60 votes needed to take up the legislation in the face of staunch opposition from Republicans, who said that private insurers and their agents, known as pharmacy benefit managers, were already negotiating large discounts for Medicare beneficiaries.

Fifty-five senators, including 6 Republicans, supported a Democratic motion to limit debate and proceed to consideration of the bill, while 42 senators voted against it. Such motions require a three-fifths majority under Senate rules. Without a limit on debate, opponents can prevent legislation from ever coming to a vote.

The Senate had only a brief debate on the merits of the legislation, which is a high priority for the new Democratic majority in Congress.

Republicans framed the issue as a choice between government-run health care and a benefit managed by the private sector. The drug benefit is delivered and administered by private insurers, under contract to Medicare.

http://www.nytimes.com/2007/04/18/washington/18cnd-medicare.html

Ironman says

Easy question for you, why didn't the Dems include that when they passed Obamacare and had full control of Congress and the White House?

There are Demoncrats who will vote along with Republicans. The so-called Blue Dog Democrats would never have voted for single payer during Obummer's first term. And there were a number of Demoncrats who blocked Bernie's recent bill.

These Democrats just voted against Bernie's amendment to reduce prescription drug prices. They are traitors to the 99% and need to be primaried: Bennett, Booker, Cantwell, Carper, Casey, Coons, Donnelly, Heinrich, Heitkamp, Menendez, Murray, Tester, Warner. self.SandersForPresident
submitted 2 months ago by gideonvwainwrightOhio - Bernie Squad - Cadet
The Democrats could have passed Bernie's amendment but chose not to. 12 Republicans, including Ted Cruz and Rand Paul voted with Bernie. We had the votes.
Here is the list of Democrats who voted "Nay" (Feinstein didn't vote she just had surgery):
Bennet (D-CO) - 2022 https://ballotpedia.org/Michael_Bennet
Booker (D-NJ) - 2020 https://ballotpedia.org/Cory_Booker
Cantwell (D-WA) - 2018 https://ballotpedia.org/Maria_Cantwell
Carper (D-DE) - 2018 https://ballotpedia.org/Thomas_R._Carper
Casey (D-PA) - 2018 https://ballotpedia.org/Bob_Casey,_Jr.
Coons (D-DE) - 2020 https://ballotpedia.org/Chris_Coons
Donnelly (D-IN) - 2018 https://ballotpedia.org/Joe_Donnelly
Heinrich (D-NM) - 2018 https://ballotpedia.org/Martin_Heinrich
Heitkamp (D-ND) - 2018 https://ballotpedia.org/Heidi_Heitkamp
Menendez (D-NJ) - 2018 https://ballotpedia.org/Robert_Menendez
Murray (D-WA) - 2022 https://ballotpedia.org/Patty_Murray
Tester (D-MT) - 2018 https://ballotpedia.org/Jon_Tester
Warner (D-VA) - 2020 https://ballotpedia.org/Mark_Warner
https://www.reddit.com/r/SandersForPresident/comments/5nicm2/these_democrats_just_voted_against_bernies/

Ironman says

Why do you think the US spends so much more on the senior citizens with Medicare (socialized government healthcare) compared to the other countries below that have socialized government healthcare?

On the other hand, Americans' risk of dying in later years is lower than that in many European nations whose health care systems are being touted by some as a model for the United States.

Looking only at deaths caused by disease, Dr. Fischbeck's analysis shows that American men have a survival advantage over men in Western Europe that increases steadily after age 65. American women gain a similar advantage starting later, at about age 80.

Putting it another way, if Americans died from diseases at the same rate as people in the Netherlands, for instance, there would be 60,000 more male deaths and 14,000 more female deaths in the United States -- all coming after age 70 -- his tables show.

A notable exception is France, which has much lower disease-related death rates than America throughout the lifespan. If Americans died at the French rate, his figures show, there would be 76,000 fewer male deaths and 242,000 fewer female deaths.

Still, Americans fare better than most Western Europeans in the latter part of the Medicare years. Dr. Fischbeck said it's important to keep that in mind as Congress winds its way toward a final health care reform bill.

"These numbers show there's something really unusual going on here," he said. "Congress is talking about reducing Medicare payments into the future, but if it's thinking about that without the possible impacts on survivability, that's only one side of the argument."

http://www.post-gazette.com/nation/2009/12/13/U-S-health-care-costs-for-the-aged-are-sky-high/stories/200912130214?pgpageversion=pgevoke

Blurtman says

These Democrats just voted against Bernie's amendment to reduce prescription drug prices. They are traitors to the 99% and need to be primaried: Bennett, Booker, Cantwell, Carper, Casey, Coons, Donnelly, Heinrich, Heitkamp, Menendez, Murray, Tester, Warner.

Thanks for calling out the names of the traitors!

Booker and Menendez have lots of Rx behind them, all along US 1 and 287.

Blurtman says

A notable exception is France, which has much lower disease-related death rates than America throughout the lifespan.

It's the red wine.

Might be cheaper and more cost effective than Medicare to buy every adult a bottle of red wine every 2 to 3 days.

Ironman says

Blurtman says

Bernie would have allowed

Ya really think so?? Bernie hasn't got shit done in Congress in 20 years...

Just like Paul Ryan who has gotten something like 2 bills he wrote passed in 18 years.

Blurtman says

On the other hand, Americans' risk of dying in later years is lower than that in many European nations whose health care systems are being touted by some as a model for the United States.

I wonder why you didn't put up the rest of the article where other researchers question the benefits?

I notice the term "disease" isn't defined. I would say a big part of that is the extensive treatment of people in terminal stages of diseases. They get strung along, at a very high cost, until they die of a heart attack or stroke. Europeans make much higher use of hospice.

rando says

Might be cheaper and more cost effective than Medicare to buy every adult a bottle of red wine every 2 to 3 days.

Or you could eat fruit and get the same health benefits. It's not like it's the alcohol that makes it healthy.

Ironman says

bob2356 says

Paul Ryan

This thread was about Paul Ryan???? Gee, I must have missed that.

You brought up the subject of how effective people were in congress.

Ironman says

bob2356 says

You brought up the subject of how effective people were in congress.

No, I brought up how effective BERNIE was in Congress.... Please try and keep up!!

Yep, more effective than the speaker of the house. Glad you brought that up.

Ironman says

Once you figure that out or answer it honestly, you'll know why giving "Medicare for All" won't work in OUR country.

A better question from my view is, since on average probably 95% (or more) of the dollars spent per person on health care in their lives happens when they are over 65, and most of that is covered by medicare, how in the hell can we account for people having to pay often over 10K per year insure their families with high deductible major medical when they are younger ?

I don't see the logic in your point at all. I'm sure you're response will be something like "that's becasue I'm a dumb dumb poopy head" (or something equally childish). But I'm serious.

YEs health care is way too costly in America and of course since it's so costly, the amount spent per person when we are older which is when they deal with end of life type heath care, is ridiculously high.

But it's extremely hard to imagine that if done right, single payer wouldn't bring costs down. There is some fraud and abuse that has to be watched, and then there will also be the issue of supplemental policies, and how they might lead to inflated prices and markets splitting to serve different segments of society.

But it's no no brainer, and it's not really "socialized medicine." It's single payer, which means one insurance company run by the government, payed for the same way medicare is funded now.

I was hoping you would explain this. How do you explain it ?

Ironman says

Once you figure that out or answer it honestly, you'll know why giving "Medicare for All" won't work in OUR country.

MY view is that most of us now pay something like 10K per year or more (or our employer does) for health insurance and only need maybe $1k per year or much less in actual health care. Why not pool the catastrophic risk (sometimes called 'major medical') part of our health care needs along with all of the old people, in medicare. And then buy cheap "supplemental policies" to cover going to the doctor for the sniffles, or a cist removal, or whatever ?

Ironman says

What happens when that same out-of-control system is implemented for 320 million?

Currently, everyone yes everyone that deals with end of life extreme health issues such as extended cancer, heart bypass surgery, kidney dialysis, and many types of extremely expensive life extension therapies are covered by and these are largely paid for with the medicare system. That is unless they are fortunate to just be healthy until they are 93, and then die in their sleep. IT's not the health care that the healthy 68 year old receives that drives up your graph. You might note that it starts spiking up well before medicare kicks in. Sure it accelerates later, but that coincides with the distribution of end of life care. Some make it into their 80s or later before they have serious health problems, but some start having a fair amount of serious and expensive problems way sooner. Far more people are starting to have expensive health care needs at 62 then at 52 or 42.

That's what drives up your graph. It's not about medicare. If it were about medicare, you wouldn't see so much of a spike before 65.

Ironman says

Why does OUR country ramp up??

Because we pay a lot more for health care, and most of the health care we receive occurs when we are old.

That's really not that complicated.

It may be true that medicare has not been effective at keeping costs down or even partly the cause of allowing it to be as expensive as it is. Our senior also buy supplemental policies that allow them to buy premium care. I'm not suggesting that i reforms might not be needed, but it's a good place to start.

I think your graph actually argues the opposite way, if it's understood. Such a small percentage of our major medical (catastrophic cost) health care occurs before the age of 60 (which is what your graph shows), that it's absurd that everyone is paying as much as they do for health insurance when they are young, with small probability of needing the super expensive kind of care.

Ironman says

That graph is for the SAME age brackets in the different countries, so all the senior citizens should be experiencing the same medical issues as they age. Why does OUR country ramp up??

Because other countries don't spent huge sums of money extending death. People in other countries get palliative care to be comfortable. That's a cultural issue, not a health care system issue.

Ironman says

Ahhh... finally...

You could understand my point of view if you wanted to.

Also, Bob is largely right, but it doesn't mean that it's not also true that more people have diabetes and heart disease here than in most of those countries, and yes we pay way more for all types of treatments here than there. That's still true, and I don't think he was denying it.

Ironman says

bob2356 says

Because other countries don't spent huge sums of money extending death.

Except the chart ramps up WAY before the average life expectancy today, sorry, please try again...

Apparently you don't understand the term AVERAGE life expectancy.

marcus says

Ironman says

Ahhh... finally...

You could understand my point of view if you wanted to.

Ironman says

marcus says

also true that more people have diabetes and heart disease

So, that only starts in people AFTER 65, that's your argument for the ramp up??? Really??

Maybe I was wrong about you understanding. What was I thinking ?

marcus says

Ironman says

Why does OUR country ramp up??

Because we pay a lot more for health care, and most of the health care we receive occurs when we are old.

That's really not that complicated.

And the ramp up starts way before 65.

If you weren't so hung up on the adversarial confrontational aspect of conversation/debate you might actually learn something. And you might be able to lose when you are wrong, more gracefully. But then that's not really what trolling is about is it.

Ironman says

They just live longer than us...

This is relevant how? Your original chart is spending by age. Trouble with math concepts again.

So lets try something simpler. if average age is 74 and someone dies at 94 then what age does someone else have to die for the average to work out? It's ok to use fingers and toes. OMG it's before 65. How did that happen?

rando says

Thanks for calling out the names of the traitors!

Both of the senators from NJ, including "Stanford carpetbagger" Cory booker

Ironman says

They just live longer than us..

I wonder how much of that can be attributed to poverty in this country, that is dietary habits of our poor, lack of health care, murder rates, etc.

The difference shrinks some at 60, but those poor folks with less health care and other factors working against them are still in there. So I reckon expecting 85 at 60 in America if you're middle class is not that far out of line (as an average that is) .

http://www.helpage.org/global-agewatch/population-ageing-data/life-expectancy-at-60/

Ironman says

bob2356 says

How did that happen?

You posting straw men again... it's typical... when you lose an argument too...

You said

"Ironman says

marcus says

also true that more people have diabetes and heart disease

So, that only starts in people AFTER 65, that's your argument for the ramp up??? Really??

What straw man do you see? You say that people that die at 50 or 55 or 60, yes people do have to die before 65 to make the average work (sorry to drag you into the idea of math, I know it always baffles you), don't get heart disease or disabilities or cancer or other expensive chronic conditions? Sorry but yes they do. The 2 leading causes of death 50-59 are heart disease and cancer.

Yet another imaginary smack down for ironbrain.

Ironman says

The reason is Medicare, patients don't give a crap what the costs are and doctors can bill for what ever procedure, treatment, test, surgery, etc. they want because it never gets turned down or rejected by Medicare. What ever the doctor "orders" is what's done. No price checks, no questions, no nothing.

I don't know the exact extent to which that's true. But to the extent it is true, I think we both (boomers) know that with our generation that's going to have to be dealt with, becasue it's a demographic bubble, and it simply is not sustainable.

But that's beside the point of our discussion. Old people almost always need some very expensive "major medical" treatments, procedures, therapies or whatever. Where as younger people usually don't. I don't believe pooling just the high risk and also the low probability major medical people (below age 65) into the pool covered by medicare would cost nearly what we are paying for it now through insurance companies. But this would be just for the major medical part of their coverage.

I don't believe anything you have said here provides the slightest evidence that I'm wrong.

Ironman says

The reason is Medicare

Then how do you explain the sharp rise before 65 ? Sure it's not as high as later ages, but neither is the amount of health care being delivered.

Ironman says

doctors can bill for what ever procedure, treatment, test, surgery, etc. they want because it never gets turned down or rejected by Medicare.

I have lived in two countries with universal health care where doctors order whatever procedures they think are necessary and they don't get turned down.

marcus says

. I don't believe pooling just the high risk and also the low probability major medical people into the pool covered by medicare would cost nearly what we are paying for it now through insurance companies.

You have any peer reviewed research on that? Otherwise it's just a stab in the dark.

I'm against medicare for all because the medicare system has many of the same expensive problems are insurance companies. Especially bill by procedure which has so many conflicts of interest and costs so much to operate. Using for profit hospitals/labs/imiging centers/ etc. socking a profit onto every single item and procedure is a problem also.

Why medicare for "all" anyway? Most people get insurance through work. The original point of ACA was to cover the uninsured, not to reduce costs of health care. It became a very expensive, convoluted way to go about it. It would have been much simpler and far cheaper to tack a piggy back health system onto the VA. The uninsured could pay pro rated based on income. With so many years of data the actuarial info would be child’s play to calculate. The VA model eliminates almost all the problems with medicare. Doctors are employees, not billing by each thing they do. There is no incentive for tacking on extra tests or visits or for committing fraud. There is no expensive billing system since doctors are salaried. There is no profit on anything, it goes at cost. Which is heavily negotiated with vendors, including drugs. There would be no cost to planning. Everything is already up and running, it would just have to be expanded. Expansion could have been incremental done in step with the amount of people signing up.

Yes the VA has had problems come up. It's a huge system and any huge system is going to have problem spots pop up.

Never going to happen now ACA is running. The insurance companies and hospitals would never allow the competition.

bob2356 says

I'm against medicare for all because the medicare system has many of the same expensive problems are insurance companies

Bernie and Elizabeth sometimes forget about costs. Agree VA is much closer to a good vision of single payer than Medicare for all.

Ironman says

The reason is Medicare, patients don't give a crap what the costs are and doctors can bill for what ever procedure, treatment, test, surgery, etc. they want because it never gets turned down or rejected by Medicare. What ever the doctor "orders" is what's done. No price checks, no questions, no nothing.

That's crap and if you don't know it then you don't belong in this discussion. Medicare denies claims all the time. Google medicare deny claims and see how many hits you get.

bob2356 says

You have any peer reviewed research on that?

No. But it should be easy enough to look at Canada, Australia and France as fairly clear evidence of how it would work. You're advocating something more along the lines of the british model . One would think that being the last ones in the first world to implement Universal health care, we should be able to learn from the mistakes of others, as well as our own (with medicare).

Would you want to eventually move all the medicare people onto this VA model making it the model for a universal health care system here ?

That seems insane to me in terms of the magnitude of the disruptive transition, where as the main disruption with medicare for all would be to the insurance industry, which you have either way. I believe that Canada, France and Australia prove that it can be done. IT would be far easier to get doctors on board for this than it would be to make such a radical shift to entrenched systems in which they become employees of the state.

marcus says

Would you want to eventually move all the medicare people onto this VA model making it the model for a universal health care system here ?

You didn't pay attention. I said that the VA model should have been used for people who didn't have health insurance instead of the aca abortion. That was right after I said most people have insurance through work. There is zero disruption, everyone with insurance continues on just as they are. Everyone without insurance would have a way to get a basic level of health care.

marcus says

But it should be easy enough to look at Canada, Australia and France as fairly clear evidence of how it would work. You're advocating something more along the lines of the british model

What I'm advocating is like the Beveridge Model with public doctors and hospitals. But I'm only advocating it for people who don't have health care to provide a basic safety net and people would pay on a means tested basis with taxes being a subsidy for the shortfall. The NIH (which is terribly implemented) is the Beveridge model but so is Spain, Scandinavia, New Zealand. and Hong Kong.

You are mish moshing together the other two other big types of health systems. The The Bismarck Model found in Germany, of course, France, Belgium, the Netherlands, Japan, and Switzerland which has non profit health insurance plans with everyone covered using private doctors and hospitals. The National Health Insurance Model in Canada, Taiwan and South Korea has private doctors and hospitals with a government run insurance plan.

Funny you picked Canada, France, and Australia. I lived in Canada for almost 2 years and I am a permanent resident of both France and Australia. I have seen the ins and outs of all three of the countries health systems. They all work pretty well no matter what the people who have never travelled further than their state fair say. I'm a NZ citizen and have the ability to say the Beveridge model can also work well if well implemented.

There is zero chance any of the systems will be implemented in the US on a national basis. You are pissing in the wind if you think it will. There is far too many wealthy investors and highly paid executives making far too much money with far too much influence on the political system for that to ever happen.