patrick.net

Yeah then it's just one entity to outsource.

Anything short of a Federal Medical Army and adequate medical practicing facilities. Is just Government meddling to make other people rich. No system will ever be a baby bottom smooth ride. Might as well go by the most beneficial method. And perhaps fees could be income based as well.
Regardless the model, ailment shouldn't bankrupt any family regardless of socioeconomic standing.

A Government Ran Health Agency.
We're past insurance, we need actual help with the fucking bills and the service. We don't need more useless Shitbags working in multi layers of entrenchment eating the bulk our health care expenses. While we're still on the hook for what should be the honest price in the first place.

For all citizens. Not for illegals. As Dems would never agree to this, it doesn't have a chance, I am afraid.

As long as we are only talking about US citizens it has to be all in or nothing. Anything else and its just milking taxpayers and will be taken advantage of by third parties like every other half ass government program. Would also like to see a two tier system one for people that work and contribute to society or are children and one that is for people that are just drainers.

Illegals already get free health care.

Moronic thread. Sure right congress is going to open up medicare for all and BTW change federal law so illegals can use is. Idiotic.

tovarichpeter says

Medicare for All is the realistic solution

No it's not.

Tenpoundbass says

A Government Ran Health Agency.

We already have a government run health agency. Its called the VA, which despite critics who are very interested in turning it over to their corporate donors to make big bucks on, does work pretty well. If Obama wanted to actually help the uninsured rather than the insurance industry he could have opened up the VA to the uninsured, after expanding it to handle the load, with a sliding premium scale based on income. No muss, no fuss, everything is already in place and operating. The only work would have been calculating the premiums, which would have been nothing since there is 70 years worth of real data right there. No guess work needed. That would have beat the shit out of spending billions on developing 51 health exchanges and taking a bunch of SWAG (scientific wild ass guesses) on how much things were going to cost. .

bob2356 says

Its called the VA, which despite critics who are very interested in turning it over to their corporate donors to make big bucks on, does work pretty well.

I'm quite certain any failings of the VA is the result of special interests lobbying like hell to make it fail.
The VA has been undermined by our own government and pundits since the day it was founded. If there were honest failings in the VA you would think the incompetence, the bad management and the handling of the VA would have been investigated and fixed Years ago. But the talking heads make it sound like a systemic inherent problem with Government ran health care to protect their private health care interests. They aren't interested in a working efficient health care system ran by the Government it's a threat to everything they hold dear at the bank.
We would have had a Civic minded Healthcare system years ago if that were not the case.

They even managed to brainwash the most Patriot of the Patriots of Americans that honestly believes there's nothing America can't do if we set our minds to it. Into believing America can do anything but have a beneficial health care system ran by the government. There's just no "Can Do" spirit there, the brainwashing is too deep.

VA could perhaps be pretty good if there was some sort of accountability on all levels. When they killed my dad my local congressmen that I was working with told me he was shocked at how powerless he was to do anything to help me dad while he was there. I spent a lot of time there with my dad and the amount of waste that I witnessed was insane.

bob2356 says

tovarichpeter says

Medicare for All is the realistic solution

No it's not.

bob2356 says

We already have a government run health agency. Its called the VA, which despite critics who are very interested in turning it over to their corporate donors to make big bucks on, does work pretty well.

Medicare works pretty well too.

Strategist says

bob2356 says

We already have a government run health agency. Its called the VA, which despite critics who are very interested in turning it over to their corporate donors to make big bucks on, does work pretty well.

Medicare works pretty well too

Medicare has most of the built in problems of the private system. A huge overhead cost for billing and a fee for service model which is ripe for fraud and over treatment. . Medicare is prohibited by law from negotiating drug prices (thanks george bush).. Any and everything paid for by medicare from an Tylenol tablet to brain surgery is subject to multiple profit mark ups. There is a gigantic bureaucracy devoted to managing the setting of fees to be paid. The only real advantage Medicare has is it is funded by taxes rather than hundreds of insurance companies that must advertise, collect premiums, pay out claims, pay executive salaries, pay out dividends. pay for lobbying, negotiate fees with doctors and hospitals, etc., etc. etc. which all adds (a lot) to the cost of health care while providing zero actual health care.

The VA is more like denmark or iceland's systems. Doctors are employees. There is no billing costs and no incentive to over treat. The VA negotiates for better prices on drugs. There is no profit mark ups across the board for each and every item. The VA in general does a good job. Especially considering they treat 9 million people in 1200 facilities, many with really unique and severe issues. There have been problems, but in any system that large there are going to be problems even in the private sector.

Remove health care from Employment.
It was a relic from the Shitty disastrous "New Deal" era policy.
Originally the New Deal policy was All Employees must make the same thing for a job regardless of the company.
It killed the labor market, the only way employeers could attract quality candidates was to offer benefits.
Then the benefits package was born, and they reversed the pay the same policy from the new deal.

As a result the free market retirement and health care options don't exist. We are at the mercy of the employer that MIGHT employ you.
If you don't get a good job and win the benefits lottery there. You're retirement and health care will be shit.

Tenpoundbass says

We are at the mercy of the employer that MIGHT employ you.
If you don't get a good job and win the benefits lottery there. You're retirement and health care will be shit.

This is by design, not by accident.

The goal of US Chamber of Commerce is to beat down labor and make it fearful and obedient. That is its entire purpose. Donations from large employers make it by far the largest lobbyist in DC:

Lobbying Client 2017 Total
US Chamber of Commerce $82,190,000
National Assn of Realtors $54,530,861
Business Roundtable $27,380,000
Pharmaceutical Research & Manufacturers of America $25,847,500
Blue Cross/Blue Shield $24,330,306
American Hospital Assn $22,074,214
American Medical Assn $21,535,000
Alphabet Inc $18,150,000

https://www.opensecrets.org/lobby/top.php?showYear=2017&indexType=sshowYear=2017&indexType=s

If employees had portable health insurance, they might lose their fear of getting fired, and that takes away from employer control over labor. So the CoC has consistently blocked all initiatives which would help people get insurance independently of their employer for the same cost. So for example, employers get to deduct the cost of medical premiums, but ordinary individuals do not get that same right:

Employer-paid premiums for health insurance are exempt from federal income and payroll taxes. Additionally, the portion of premiums paid by employees is typically excluded from taxable income as well. The exclusion of premiums lowers most workers’ tax bills and thus reduces their after-tax cost of coverage. This tax subsidy partly explains why most American families have health insurance coverage through employers.

More about the CoC:

https://www.economist.com/node/21553020

WarrenTheApe says

Personally, I think government should just get out of health care altogether. It is only a mess because it got involved and then more involved to 'fix' things. But this would be easy to implement even for the morons that constitute our federal civil service and the even worse morons writing the legislation in Congress. And it would be popular.

f you think sky high private insurance premiums for medicare age people are going to be popular then I have a shitload of slightly damp land in florida to sell you. That is also the group that votes the most so trust me that the morons in congress won't dumping them off heavily subsidized medicare into expensive private insurance any time before the next ice age.

bob2356 says

f you think sky high private insurance premiums for medicare age people are going to be popular then I have a shitload of slightly damp land in florida to sell you.

How much were premium increases arrested or even reversed under ACA during the Obama years?

bob2356 says

The VA is more like denmark or iceland's systems. Doctors are employees. There is no billing costs and no incentive to over treat. The VA negotiates for better prices on drugs. There is no profit mark ups across the board for each and every item. The VA in general does a good job. Especially considering they treat 9 million people in 1200 facilities, many with really unique and severe issues. There have been problems, but in any system that large there are going to be problems even in the private sector.

bob2356 says

f you think sky high private insurance premiums for medicare age people are going to be popular then I have a shitload of slightly damp land in florida to sell you.

So you would support a VA system for all of America? It would also cut down on the practice of "defensive medicine" and the large slice that goes to lawyers.

TwoScoopsPlissken says

bob2356 says

f you think sky high private insurance premiums for medicare age people are going to be popular then I have a shitload of slightly damp land in florida to sell you.

How much were premium increases arrested or even reversed under ACA during the Obama years?

Huh? How is this relevant to the idea of dropping everyone out of medicare and making them buy private insurance?

Strategist says

So you would support a VA system for all of America? It would also cut down on the practice of "defensive medicine" and the large slice that goes to lawyers.

That would be a public health care system in the Beveridge model. Government owns the health care facilities and doctors are employees. There are a number of countries using this model with good success. Spain, NZ, Hong Kong, Scandinavia, Cuba, and the originator Great Britain which is the least successful. There is also the Bismark model, National Health Insurance model, and of course the out of pocket model, aka no public health care.

I would support a Beveridge model, not necessarily the VA. I lived for many years in a Beveridge system and it worked well. BUT, public health care is never going to happen in the US. There is far, far too much profit in the current model being made by people and institutions with powerful political influence aka major campaign contributors. The US truly has the most corrupt democracy in the world and it's all perfectly legal.

What I am saying is it would have been much more sensible (and still would be sensible) to roll the uninsured (the entire point of the ACA supposedly) into an expanded VA and charged them income based premiums rather than the all consuming damn the expense monster called ACA. But that would mean knowing the difference between the cost of health care and the cost of health care insurance which Obama either didn't understand or he got rolled by the insurance carriers or if he was so desperate to keep a campaign promise he didn't care. Plus if the VA starting charging people what it actually costs for their health care they would end up stealing people that are buying their own insurance from private insurance (and private insurance profits) right and left. Not going to happen.

WarrenTheApe says

bob2356 says

f you think sky high private insurance premiums for medicare age people are going to be popular then I have a shitload of slightly damp land in florida to sell you.

I didn't say that. Learn to read.

''

WarrenTheApe says

Personally, I think government should just get out of health care altogether.

Sorry, please explain the other meanings of "the government should get out of health are altogether". I thought it was very unequivocal but apparently not.

bob2356 says

I would support a Beveridge model, not necessarily the VA. I lived for many years in a Beveridge system and it worked well. BUT, public health care is never going to happen in the US. There is far, far too much profit in the current model being made by people and institutions with powerful political influence aka major campaign contributors. The US truly has the most corrupt democracy in the world and it's all perfectly legal.

With $trillions at stake, the potential losers will fight tooth and nail to the bitter end. It's gonna be like moving a mountain.

WarrenTheApe says

The whole reason why health care is expensive is because of the government. Period.

Because most politicians are in the pockets of special interests.

WarrenTheApe says

The whole reason why health care is expensive is because of the government. Period.

Its because they are only involved to make corporations profit, just like everything else they get involved in, it has to be all or nothing. I just fear our government is no longer capable of doing great things, all sides are so suspicious of each other and the sad thing is that they should be.

Without competition, it’ll fail.

Only private sector can produce anything good and sustainable.

FortWayne says

Without competition, it’ll fail.

Only private sector can produce anything good and sustainable.

Capitalism and competition are wonderful, but there are times when it fails and the government has to step in. In the case of our healthcare, capitalism and competition has failed to bring about affordable healthcare. Costs are insane compared to the rest of the developed world. It clearly needs fixing.
As a family we have great health insurance through a major corporation where my wife works just enough hours to qualify for the benefits. I am self employed. Our out of pocket expenses I believe are close to $10K per year. We still worry about healthcare because the system is so screwed up.
We even have health insurance for our precious German Shepherd. She was hospitalized for 36 hours last month and the total cost was $3,000 plus the follow ups. This is absolutely insane.

Break monopolies, costs will drop.

Healthcare is heavily monopolized.

Strategist says

FortWayne says

Without competition, it’ll fail.

Only private sector can produce anything good and sustainable.

Capitalism and competition are wonderful, but there are times when it fails and the government has to step in. In the case of our healthcare, capitalism and competition has failed to bring about affordable healthcare. Costs are insane compared to the rest of the developed world. It clearly needs fixing.
As a family we have great health insurance through a major corporation where my wife works just enough hours to qualify for the benefits. I am self employed. Our out of pocket expenses I believe are close to $10K per year. We still worry about healthcare because the system is so screwed up.
We even have health insurance for our precious German Shepherd. She was hospitalized for 36 hours last month and the total cost was $3,000 plus the follow ups. This is absolutely insane.

Tenpoundbass says

Originally the New Deal policy was All Employees must make the same thing for a job regardless of the company.

Total horseshit, unless you're referring to union rules. Unions were a great thing for american workers. Funny how right wingers want to make America great again, but they forget that when ameriica was great, unions were much stronger.

The worker has less and less leverage all the time. And the typical anti public sector right winger seemingly wants the owners to take away even more leverage from workers.

THe idea of some kind of national health program like they have in England, or the VA is nice, but I agree with the OP. Medicare for all is a no brainer at this point. Medicare is already paying for most of the most expensive health care that occurs late in life anyway for the entire country. THe most efficient thing would be to bring the rest of health care in to the same system. And then find ways to lower costs.

marcus says

And then find ways to lower costs.

Lower costs means lower GDP. What do you think grew economy of the financial crisis - ObamaCare.

Wrong. The rate that health care costs were going up decreased under Obamacare. (not including the cost to the govt, of increased medicaid etc. for low income folks).

Valid point though, that health care is a big part of our economy.

Patrick says

More about the CoC:

My wife loves the CoC

marcus says

Medicare for all is a no brainer at this point.

Gross

marcus says

Tenpoundbass says

Originally the New Deal policy was All Employees must make the same thing for a job regardless of the company.

Total horseshit, unless you're referring to union rules. Unions were a great thing for american workers. Funny how right wingers want to make America great again, but they forget that when ameriica was great, unions were much stronger.

Actually tpb has it vaguely right.. The 1942 Stabilization Act froze wages to avoid inflation during the war. Employers started offering health care instead of raises.

marcus says

but I agree with the OP. Medicare for all is a no brainer at this point. Medicare is already paying for most of the most expensive health care that occurs late in life anyway for the entire country. THe most efficient thing would be to bring the rest of health care in to the same system. And then find ways to lower costs.

A no brainer? Have you taken a serious look at how much FICA will have to be raised to cover medicare A and medicare tax and general income taxes to pay for part B & D? You might not be so enthusiastic. Bernie says 1.4T per year to pay for medicare for all. That is a ridiculously low number even by political promises standards. Even that low ball number would require raising income taxes by something like 10% across the board right down to the lowest earners. Without doing anything to lower the costs of health care since medicare has the same cost problems as private insurance. Actually worse since medicare is prohibited from negotiating drug prices. Like ACA medicare for all merely shifts from health care insurers or uncompensated care to taxes. It doesn't matter if you are taking the money out of the left pocket (health insurance companies) or the right pocket (taxes) if the bill is the same. Health care cost is not the same thing as health care insurance cost.

Ass, gas, or grass. No one rides free.

bob2356 says

The only real advantage Medicare has is it is funded by taxes rather than hundreds of insurance companies that must advertise, collect premiums, pay out claims, pay executive salaries, pay out dividends. pay for lobbying, negotiate fees with doctors and hospitals, etc., etc. etc. which all adds (a lot) to the cost of health care while providing zero actual health care.

Wrong. Medicare has insurance carriers that do all of those things. Also funny how you classify normal business operations as "providing zero actual health care" while lamenting the waste of a bureaucracy.

The solution is a free market system, which would include "insurance companies that must advertise, collect premiums, pay out claims, pay executive salaries, pay out dividends. pay for lobbying, negotiate fees with doctors and hospitals, etc., etc. etc." and less government intervention.

bob2356 says

Actually worse since medicare is prohibited from negotiating drug prices. L

Of course that would have to change. Attempts to do so in the past were torpedoed by primarily Republicans.

Would Medicare have to turn a profit or could it operate at cost, unlike the privates?

CBOEtrader says

Wrong. Medicare has insurance carriers that do all of those things. Also funny how you classify normal business operations as "providing zero actual health care" while lamenting the waste of a bureaucracy.

Wrong. Advantage carriers don't have to advertise for customers, they come from medicare. They don't have to collect and manage premiums, they come from medicare. They don't have to do fee for service billing, advantage is capitation. They don't have to manage actuarials and negotiate prices, they have capitation. Yet advantage costs more per beneficiary than the wasteful bureaucracy doing tradiitonal fee for service medicare and all the overhead work also.

What is lamanting a bureuaucracy? Lament means grieving or sorrow at a loss so that sentence makes very little sense. If you were trying to say praising then no I don't praise bureaucracies. But if they work better at something then I will acknowledge the fact rather than wallow in indefensible dogma.

CBOEtrader says

The solution is a free market system, which would include "insurance companies that must advertise, collect premiums, pay out claims, pay executive salaries, pay out dividends. pay for lobbying, negotiate fees with doctors and hospitals, etc., etc. etc." and less government intervention.

Same argument as georgism. Show me all the places this is working. Isn't greorgism great? You can get a 300 sq ft apartment in HK for only a million. I'm impressed.

MisterLefty says

bob2356 says

Actually worse since medicare is prohibited from negotiating drug prices. L

Of course that would have to change. Attempts to do so in the past were torpedoed by primarily Republicans.

and will be in the future.

bob2356 says

CBOEtrader says

Wrong. Medicare has insurance carriers that do all of those things. Also funny how you classify normal business operations as "providing zero actual health care" while lamenting the waste of a bureaucracy.

Wrong. Advantage carriers don't have to advertise for customers, they come from medicare. They don't have to collect and manage premiums, they come from medicare. They don't have to do fee for service billing, advantage is capitation. They don't have to manage actuarials and negotiate prices, they have capitation. Yet advantage costs more per beneficiary than the wasteful bureaucracy doing tradiitonal fee for service medicare and all the overhead work also.

What is lamanting a bureuaucracy? Lament means grieving or sorrow at a loss so that sentence makes very little sense. If you were trying to say praising then no I don't praise bureaucracies. But if they work be...

This isnt how how Medicare works. The client still pays a carrier. The client still chooses a carrier from those available in his area. Usually this is a name brand they feel comfortable with, which is a direct result of marketing efforts. All Medicare carriers do the dog/pony road show to convince agents to sell their products: advantage, med supps, and RX plans.

Every step mentioned is highly regulated and wasteful, sure. The process would be much improved and a fraction of the cost if it were a free market system rather so highly regulated.

marcus says

Total horseshit, unless you're referring to union rules.

Now teacher go back and read up on the Blue Eagle and Work Progress Administration policies.