A challenge to anyone who opposes Medicare for All

Discussion in 'Health Care' started by Kode, Jan 24, 2018.

  1. Richard The Last

    Richard The Last Well-Known Member

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    And while we are weeding out the worthless lets also weed out all those worthless people on Medicaid. And by that I don't mean the people who are deserving but those who are just playing the system because they are too lazy to work.
     
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  2. Seth Bullock

    Seth Bullock Well-Known Member Past Donor

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    I watched the video.

    I was disappointed that he didn't talk about what Medicare For All would cost.

    What I believe, however, is that it would cost about 25% of wages. There could be a split of that with employers, but I think that is about what it would cost.

    I did a study a while back and put it on this page ... http://www.politicalforum.com/index...-healthcare-can-be-accomplished.500686/page-3

    Even though I am fairly conservative on most things, I do think the country is better off when all people can get the health care they need, and they can afford it. So I am open to ideas and discussion on the subject.

    California, the most liberal state in the union, and the richest, with Democratic super majorities in both state houses and a liberal Democratic governor, recently flirted with the idea of single-payer in their state. They could have taken advantage of existing federal programs - Medicare for seniors and Medicaid for the poor - and instituted a tax-supported single payer program for the people in between the poor and the aged. But both state houses tossed the ball back and forth to each other, neither one willing to propose a tax package, and the idea died.

    I actually hoped they would do it, just to see if it would work. I thought it was very telling that they didn't want to pay for it. And those liberal politicians who wouldn't fund it refused to fund it for one reason. And that reason is that their liberal constituents didn't want them to. Because if you tax people for it at a certain rate per dollar of income, at a certain income level you are paying more for health care than you used to under our present system. And the more you make, the more you pay. So, for example, let's say a household of 4 making $200k (not uncommon in California) presently pays $15k for health insurance for the family. But if they had to pay a tax of 15% for single payer, they would pay $30k. If the tax was 20% they would pay $40k. And the higher the income, the more you pay above what you used to pay.

    The cynic that I am, I sort of smirked at our uber-liberal neighbors to the south when they let the measure die. It speaks to the fact that well-to-do liberals may talk a good game, but when the rubber hits the road ... not so much.

    In the past, I have suggested a compromise. But, as is true of compromises, there is something in it to hate for everyone, both libs and cons. It would get everyone covered, however.

    Seth
     
    Last edited: Feb 3, 2018
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  3. Lil Mike

    Lil Mike Well-Known Member

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    I too am a supporter of left leaning states that want Single payer to go ahead and do it. Vermont promised...then passed, and Colorado tried to float that balloon as well. California would have been an interesting experiment, so I supported their attempt, but as soon as they get to the point when they see the bill, the plans die in darkness (just like democracy).

    Of course, California's proposed plan was idiotic, much like Bernie Sander's plan.
     
  4. Seth Bullock

    Seth Bullock Well-Known Member Past Donor

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    I don't know the details of California's plan, but I remember it started in the lower house, and they passed it and sent it to the upper house - with no means of funding. The upper house also didn't fund it, and, as I recall, there was a little bit of political finger pointing ... and then it died in the upper house.
     
  5. Kode

    Kode Well-Known Member

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    We discussed this somewhere previously. But I just wanted to say that the issue of "over-taxation" for high incomes can be managed. The point is to deliver services for less cost, and since the US is way, way above every other country in per capita spending on this, I'm confident we can deliver on that goal. It will require extensive change but it will swap several existing costs we pay for healthcare today for one smaller payment, saving us the difference. And what we commonly see in the warnings of naysayers is an omission of any mention of the savings, and an implication that the new tax would be added onto what we already pay. And of course that is dishonest of them. You didn't do that.

    So all-in-all, this is something we could do with success.
     
  6. Seth Bullock

    Seth Bullock Well-Known Member Past Donor

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    I agree that we could do it because, really, we can do anything we want to do. But that is the question, isn't it? I know you want to. And there is some support for it. But does the majority want to? And this is why I brought up California.

    How do you manage the issue of over taxation on high incomes? Even now, high income people contribute a lot more to Medicare than low income people. High income people also contribute more to Medicaid because they pay the most taxes. In the case of Medicare, no one really complains about this because the contribution is only 2.9%, and that cost is split between the employer and the employee. And, of course, there is no separate tax for Medicaid. It's hidden in the cost of general taxation by the federal government and the states.

    Now if you institute single-payer, and you limit the amount high income people are taxed for it, more of its cost is then shifted to the middle and lower income people. Would that fly? But if you have a constant rate (like we do now with Medicare taxation) higher income people would have to pay a lot more than lower income people. If that rate is 20%, and you earn $500k, 20% is $100k. Would that fly? And this is where I think there would be a lot of pushback, including from well-to-do liberals as we saw in California. Ha! I wonder if Sean Penn, Oprah Winfrey, and Barbara Streisand really want to pay hundreds of thousands of dollars every year for "free" health care ...

    And btw, I did some reading about the Canadian health care system, and, as I suspected, higher income people pay a lot more for their "free" health care than low income people do.

    Look. I don't need to be sold on the idea that everyone should have access to doctors, hospitals, and medicines, and that the poor should be taken care of, and it should be affordable for the rest of us. I accept the premise, and I believe that that is good for the country.

    My real interest lies in HOW, and what would it cost, and who would pay for it. I am not interested in a program that isn't fully paid for by the people which relies on government deficit spending. If we want something, we should work for it, earn it, and pay for it. I'm old fashioned that way ... Besides, when you pay for something, you value it more and don't take it for granted.
     
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  7. Chester_Murphy

    Chester_Murphy Well-Known Member Past Donor

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    With Snap benefits being proposed for pets, illegals getting government social program benefits and college tuition before citizens, it's obvious our government can easily afford Medicare for all. It's also obvious Social Security should be paid to all citizens at a rate that eliminates the need for a pension plan, IRA or 401k. Those may still be funded by private citizens, but they should not be necessary for folks to be able to live a middle class lifestyle when they retire.
     
    Last edited: Feb 3, 2018
  8. Chester_Murphy

    Chester_Murphy Well-Known Member Past Donor

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    Please list everything and every place you can think of where we can cut back to make this possible or how you would suggest it be made affordable.

    These insurance companies are paying too high a rate for services rendered. How can those rates be lowered, in your opinion?
     
  9. Chester_Murphy

    Chester_Murphy Well-Known Member Past Donor

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    @Kode,
    Should SNAP benefits be supplied for all of us before we all get health insurance? If we can't eat, we will get sick. Is this preventative care under healthcare guidelines?
     
  10. Kode

    Kode Well-Known Member

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    Answer: http://pnhp.org/blog/2016/03/01/kai...ort-medicare-for-all-is-more-than-two-thirds/

    http://www.pewresearch.org/fact-tan...er-health-coverage-grows-driven-by-democrats/

    http://www.pnhp.org/news/2017/june/...chicago-area-doctors-support-medicare-for-all

    https://duckduckgo.com/?q=majority+...or+all"+2017&t=hf&search_plus_one=form&ia=web



    High-income people should pay a bit more. But it can be limited the same as FICA taxes are limited, -with a cap of some sort.


    I think you're not seeing the bigger picture because of getting caught up in the weeds. Keep in mind that a plan must, and can, promise and then deliver a lower overall cost per person. The current per-capita cost for the average or median in each quintile can be determined. Then the plan can be designed to continue the same cost relationships as percentages for the new plan, effectively reducing everyone's personal cost in a lower-cost national plan. The only real resistance to this would be what the insurance and drug and equipment industries can whip up.


    Who said it was "free"? Nothing is free.


    I explained my idea above. Now regarding cost, studies show that preventative care is very important in keeping costs down. Review some Scandinavian countries' experience with that to see. Then there is the non-profit approach to supports and particularly the drug industry. There is plenty that can be done to bring costs down.
     
  11. Kode

    Kode Well-Known Member

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    I was unaware of insurance companies paying a rate for something. Can you elaborate a bit?
     
  12. Chester_Murphy

    Chester_Murphy Well-Known Member Past Donor

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    dodgey guy

    Just answer the questions posed, if you are able. Don't worry about that particular part of my posts. If I am mistaken, then I am, but I think you are concerned with semantics to avoid answering any question.
     
    Last edited: Feb 3, 2018
  13. Kode

    Kode Well-Known Member

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    Semantics would be games.

    Speaking of games, I'm not going to list "everything and every place" where we could save! Let me introduce you to standard forum protocol. ...

    I post my views with any supporting evidence I may have. You may question my reasoning or terminology. But to learn more about the subject I raised, at some point the reader needs to research the details to his satisfaction and then bring that back if he so wishes. This is that point. But the poster cannot be expected to run an education course to your satisfaction within the forum just so an imperfect detail or some weak point may be identified so as to provide an opportunity to claim a "refutation" of the whole thing. So go research it. There is plenty of data out there and I suspect that if you had been actually interested in the subject, you would already have those answers in the back of your mind.
     
  14. JakeStarkey

    JakeStarkey Well-Known Member

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    Chester plays a semantic game with he holding the rule book. :)
     
  15. Fenton Lum

    Fenton Lum Banned

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    New York, N.Y., October 8, 2015 — The U.S. spent more per person on health care than 12 other high-income nations in 2013, while seeing the lowest life expectancy and some of the worst health outcomes among this group, according to a Commonwealth Fund report out today. The analysis shows that in the U.S., which spent an average of $9,086 per person annually, life expectancy was 78.8 years. Switzerland, the second-highest-spending country, spent $6,325 per person and had a life expectancy of 82.9 years. Mortality rates for cancer were among the lowest in the U.S., but rates of chronic conditions, obesity, and infant mortality were higher than those abroad.

    “Time and again, we see evidence that the amount of money we spend on health care in this country is not gaining us comparable health benefits,” said Commonwealth Fund President David Blumenthal, M.D. “We have to look at the root causes of this disconnect and invest our health care dollars in ways that will allow us to live longer while enjoying better health and greater productivity.”

    http://www.commonwealthfund.org/pub...spends-more-on-health-care-than-other-nations


    U.S. Healthcare Ranked Dead Last Compared To 10 Other Countries

    https://www.forbes.com/sites/danmun...-compared-to-10-other-countries/#486bbd6f576f


    Major Findings
    · Quality: The indicators of quality were grouped into four categories: effective care, safe care, coordinated care, and patient-centered care. Compared with the other 10 countries, the U.S. fares best on provision and receipt of preventive and patient-centered care. While there has been some improvement in recent years, lower scores on safe and coordinated care pull the overall U.S. quality score down. Continued adoption of health information technology should enhance the ability of U.S. physicians to identify, monitor, and coordinate care for their patients, particularly those with chronic conditions.

    · Access: Not surprisingly—given the absence of universal coverage—people in the U.S. go without needed health care because of cost more often than people do in the other countries. Americans were the most likely to say they had access problems related to cost. Patients in the U.S. have rapid access to specialized health care services; however, they are less likely to report rapid access to primary care than people in leading countries in the study. In other countries, like Canada, patients have little to no financial burden, but experience wait times for such specialized services. There is a frequent misperception that trade-offs between universal coverage and timely access to specialized services are inevitable; however, the Netherlands, U.K., and Germany provide universal coverage with low out-of-pocket costs while maintaining quick access to specialty services.

    · Efficiency: On indicators of efficiency, the U.S. ranks last among the 11 countries, with the U.K. and Sweden ranking first and second, respectively. The U.S. has poor performance on measures of national health expenditures and administrative costs as well as on measures of administrative hassles, avoidable emergency room use, and duplicative medical testing. Sicker survey respondents in the U.K. and France are less likely to visit the emergency room for a condition that could have been treated by a regular doctor, had one been available.

    · Equity: The U.S. ranks a clear last on measures of equity. Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick; not getting a recommended test, treatment, or follow-up care; or not filling a prescription or skipping doses when needed because of costs. On each of these indicators, one-third or more lower-income adults in the U.S. said they went without needed care because of costs in the past year.

    · Healthy lives: The U.S. ranks last overall with poor scores on all three indicators of healthy lives—mortality amenable to medical care, infant mortality, and healthy life expectancy at age 60. The U.S. and U.K. had much higher death rates in 2007 from conditions amenable to medical care than some of the other countries, e.g., rates 25 percent to 50 percent higher than Australia and Sweden. Overall, France, Sweden, and Switzerland rank highest on healthy lives.

    http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror


    No other advanced country even comes close to the United States in annual spending on health care, but plenty of those other countries see much better outcomes in their citizens' actual health overall.

    A new Commonwealth Fund report released Thursday underscored that point — yet again — with an analysis that ranks 13 high-income nations on their overall health spending, use of medical services, prices and health outcomes.

    The study data, which is from 2013, predates the full implementation of Obamacare, which took place in 2014. Obamacare is designed to increase health coverage for Americans and stem the rise in health-care costs.

    The findings indicate that despite spending well in excess of the rate of any other of those countries in 2013, the United States achieved worse outcomes when it comes to rates of chronic conditions, obesity and infant mortality.

    One rare bright spot for the U.S., however, is that its mortality rate for cancer is among the lowest out of the 13 countries, and that cancer rates fell faster between 1995 and 2007 than in other countries.

    "Time and again, we see evidence that the amount of money we spend on health care in this country is not gaining us comparable health benefits," said Dr. David Blumenthal, president of the Commonwealth Fund. "We have to look at the root causes of this disconnect and invest our health-care dollars in ways that will allow us to live longer while enjoying better health and greater productivity."

    http://www.cnbc.com/2015/10/08/us-health-care-spending-is-high-results-arenot-so-good.html


    Ranking 37th — Measuring the Performance of the U.S. Health Care System
    http://www.nejm.org/doi/full/10.1056/NEJMp0910064#t=article


    Health Care Outcomes in States Influenced by Coverage, Disparities
    https://www.usnews.com/news/best-st...-in-states-influenced-by-coverage-disparities


    One explanation for the health disadvantage of the United States relative to other high-income countries might be deficiencies in health services. Although the United States is renowned for its leadership in biomedical research, its cutting-edge medical technology, and its hospitals and specialists, problems with ensuring Americans’ access to the system and providing quality care have been a long-standing concern of policy makers and the public (Berwick et al., 2008; Brook, 2011b; Fineberg, 2012). Higher mortality rates from diseases, and even from transportation-related injuries and homicides, may be traceable in part to failings in the health care system.

    The United States stands out from many other countries in not offering universal health insurance coverage. In 2010, 50 million people (16 percent of the U.S. population) were uninsured (DeNavas-Walt et al., 2011). Access to health care services, particularly in rural and frontier communities or disadvantaged urban centers, is often limited. The United States has a relatively weak foundation for primary care and a shortage of family physicians (American Academy of Family Physicians, 2009; Grumbach et al., 2009; Macinko et al., 2007; Sandy et al., 2009). Many Americans rely on emergency departments for acute, chronic, and even preventive care (Institute of Medicine, 2007a; Schoen et al., 2009b, 2011). Cost sharing is common in the United States, and high out-of-pocket expenses make health care services, pharmaceuticals, and medical supplies increasingly unaffordable (Commonwealth Fund Commission on a High Performance System, 2011; Karaca-Mandic et al., 2012). In 2011, one-third of American households reported problems paying medical bills (Cohen et al., 2012), a problem that seems to have worsened in recent years (Himmelstein et al., 2009). Health insurance premiums are consuming an increasing proportion of U.S. household income (Commonwealth Fund Commission on a High Performance System, 2011).

    https://www.ncbi.nlm.nih.gov/books/NBK154484/


    Once again, U.S. has most expensive, least effective health care system in survey

    A report released Monday by a respected think tank ranks the United States dead last in the quality of its health-care system when compared with 10 other western, industrialized nations, the same spot it occupied in four previous studies by the same organization. Not only did the U.S. fail to move up between 2004 and 2014 -- as other nations did with concerted effort and significant reforms -- it also has maintained this dubious distinction while spending far more per capita ($8,508) on health care than Norway ($5,669), which has the second most expensive system.

    "Although the U.S. spends more on health care than any other country and has the highest proportion of specialist physicians, survey findings indicate that from the patients’ perspective, and based on outcome indicators, the performance of American health care is severely lacking," the Commonwealth Fund, a New York-based foundation that promotes improved health care, concluded in its extensive analysis. The charts in this post are from the report.

    [​IMG]

    https://www.washingtonpost.com/news...care-system-in-survey/?utm_term=.3bea55276072


    US healthcare system ranks 50th out of 55 countries for efficiency
    http://www.beckershospitalreview.co...-50th-out-of-55-countries-for-efficiency.html


    he U.S. healthcare system notched another dubious honor in a new comparison of its quality to the systems of 10 other developed countries: its rank was dead last.

    The new study by the Commonwealth Fund ranks the U.S. against seven wealthy European countries and Canada, Australia and New Zealand. It's a follow-up of previous surveys published in 2010, 2007, 2006 and 2004, in all of which the U.S. also ranked last.

    Although the U.S. ranked in the middle of the pack on measures of effectiveness, safety and coordination of care, it ranked dead last on access and cost, by a sufficient margin to rank dead last overall. The breakdowns are in the chart above.

    Conservative pundits hastened to explain away these results after the report was published. See Aaron Carroll for a gloss on the "zombie arguments" put forth against the clear evidence that the U.S. system falls short.

    http://www.latimes.com/business/hiltzik/la-fi-mh-the-us-healthcare-system-20140617-column.html

    U.S. Health Care Ranked Worst in the Developed World
    http://time.com/2888403/u-s-health-care-ranked-worst-in-the-developed-world/
     
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  16. Kode

    Kode Well-Known Member

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    Whew! Pretty exhaustive, @Fenton Lum . I think you nailed it.
     
  17. Chester_Murphy

    Chester_Murphy Well-Known Member Past Donor

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    This was quoted twice in the articles. I disagree that there are root causes due to people being unhealthy. Insurance was meant to cover the unhealthy. Raise wages so folks can purchase organic food. Or, as I said earlier give SNAP to all and make it enough that they can purchase those foods which promote health. That would address the root of the issue as this fellow sees it.

    I've read studies where technology and it's use was actually one of the reasons for our expensive healthcare. Costs increased, though quality of care did not. Even some of yoru quotes claim similar.

    Most of those other 12 countires don't have the technology we do. How do they do better when they have similar issues to ours? They don't waste money. We pay double what Australia pays for the same services. A room costs like 3 times or more what they are charged. Do they have to sit in the dark alone or is someone seeing them enough? Don't know. Nothing I read spells that out.

    Again, they don't use the level of technology we do. Why are their costs less for the same exact services? These are the questions that need answered.

    The technology doesn't help, apparently. It is much more than needed and if not used, is a waste. Some articles I read said we don't give as much money to research and development as other countires. They don't have the poor numbers from amenable conditions. Why is our care more expensive when they are all doing a better job? Why would insurance companies continue to pay higher costs each year for less quality?

    Obamacare was a mistake. It is not successful because costs need to go down first. It is not successful because everyone sees us as a money tree they can continue to pluck with greater frequency as the whim hits them. It's partly our government that created these major issues. We can't expect them to fix it.

    No, I don't have the links to those. I had them earlier, but thought @Kode might answer some of my questions, eliminating the need to prove myself. There is more than one way. There always is.
     
  18. Chester_Murphy

    Chester_Murphy Well-Known Member Past Donor

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    I do and I was challenging you to come up with them and then I could give you an opposing opinion with citations or links. You don't have the only answers. There are many possible answers. It's obvious no one has one that works. You let @Fenton Lum do your work in your thread.
     
  19. Kode

    Kode Well-Known Member

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    Hey, don't bother me with games. Either post your views or don't bother me.
     
  20. Mr_Truth

    Mr_Truth Well-Known Member

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    [​IMG]
     
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  21. Kode

    Kode Well-Known Member

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    LOLOLOL!!!!!!!!!!
     
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