Universal Healthcare

How much do you think it would cost for someone over 65 to buy healthcare coverage today if it weren't for Medicare and laws on how much insurance companies can charge?

You're getting a bargain, and I can only hope you are thankful

 

No, we are not some dumb frog. We would be making these choices with our eyes wide open.

We cannot cut spending elsewhere to pay for it, and I will show you why.

Below is a chart showing Medicare's sources of income.




In the column on the left we see that 36% of Medicare's budget comes from payroll taxes. The two other major sources are premiums and general revenue. "General Revenue" is direct injections of cash from the federal government. This is deficit spending.

So, if we wished to expand/improve Medicare for seniors - providing comprehensive free health care - and fully paying for it with designated taxation, we would would have to raise the other 64% of the cost. 64% of the 2016 Medicare budget is $454 billion. We cannot take away $454 billion from the federal budget. It is not politically possible.

No, the only viable way for the government to improve health care for our citizens is to propose something, attach a cost, and see if we're willing to pay for it.

Money doesn't grow on trees. There's no free ride. And no, we can't cut half a trillion dollars from something else.

 

Medicare has proven to have low overhead and prompt service, while delivering equivalent quality as supplied by for profit and not for profit providers.

 

That's all well and good, but the question I was asking was what wrong with individual states having their own universal systems as a proof of concept? If say, California adopts a single payer system, as they've discussed doing, we could see if healthcare costs decline, and by how much.

 

And yet you are the one living in fear.

 

Medicare covers the most costly age demographic by far, and a demographic that may not be the least able to pay, but does have serious constraints in income. For example, it doesn't compare to employer healthcare where employees are buying their insurance through their work product - paid by the individual as well as by the corporation. (This is actually inefficient, as it leaves corporations managing healthcare policy, a drag on corporations and barrier to entry.)

The ablity of Medicare to manage healthcare can be compared.

But, the cost of the demographic and the impact of the revenue source would not be constant over the full population.

 

So, CA based corporations would no longer have employee healthcare programs, would no long make federal healthcare related withholdings, (such as Medicare) etc.?

 

That's true.

Our 65+ population is about 11% of us. That demographic accounts for about 31% of all health care spending. And yes, that demographic needs to have financial help with health care costs.

I am not knocking the idea of providing health care. What I am saying is that we have to be willing to pay for it. This is always the stumbling block.

 

The details of the plan are here:

SB-562 The Healthy California Act.

 

OK, but when looking for additional cost, I think you have to find those who would be helped, but who are not being helped today. That is, what additional service is being supplied. That's not going to be in the Medicare range, as the idea of Medicare for all isn't to improve Medicare for those who have it today, I think.

And, it's important to consider reasonably expectable cost savings such as the number of indigents who use super expensive ER services, the cost of people not using healthcare until disease gets serious, the cost of bankruptcies due to healthcare, the cost of work hours lost to treatable illness, the profit made by insurance companies over and above reasonable management cost, the cost (and barriier to entry) of having corporations have to manage healthcare plans, etc.

I'm not saying what the outcome of a full analysis would be. But, I think we do forget all the ways our current system impacts us.

I suspect that more careful analysis of the systems of other countries should be included in this. We have to have trust in any change we make. And, thankfully, there are numerous systems that are working today (ALL costing less than ours, even discounting the drag ours has on corporations and other such costs of our system), so we can see working examples of how specific issues are handled and what it costs.

 

I agree with Mike, and I've suggested it before. If CA instituted its own universal health care system, it wouldn't have to prohibit private insurance. But private insurance would all but disappear, unless there were gaps in the state system and insurance companies wanted to offer plans for those gaps. If there were a mandatory universal health system, employers would very likely stop paying for company-paid programs.

Of course Californians would still pay into Medicare, and have a Medicaid program. California's program would not eliminate Medicare, but it might augment it. California has just as much right to receive Medicaid funds as any other state, so their own universal program could simply augment that.

California would need to attach a "longevity of residence" clause to the whole thing to keep people from flooding California seeking only health care.

California has a huge economy and it is a dark, dark, dark blue state. There is nothing stopping them, except that California is run by the very rich class, and I suspect that that class does not want to pay more for health care than they already are.

 

I'm just saying that a partial move is not a legitimate test of Medicare for all.

Remember that we had "Romney Care". If you want to look at a partial move you could go there.

In general, any "experiment" that leaves out all those who have corporate healthcare coverage is too flawed to be relevant. It leaves out the advantage of corporations being freed. It double charges employees who have that corporate coverage. And, it has other problems that have to do with the specifics of the implementation.

 

Only if we're stupid enough to take the bait. A government that controls healthcare controls who lives or dies. No government healthcare system in the world can exist without rationing. Rationing means limiting coverage after one reaches a certain age so someone who is say eighty whose life could be spared by an expensive procedure would be denied in favor of someone younger with the same condition. How is that fair? Life is life no matter what age one is and nobody should be denied care. This is something nobody that supports Universal Healthcare wants to talk about. It's happened, it's happening and that's not the worst of it, a government that makes government run healthcare mandatory is a government that can mandate abortion, that will let people die who otherwise wouldn't, will eventually cover assisted suicide and even float mandatory euthanasia. It is a matter of time because for sheeple if it's provided by the government it's got to be good,right?

 

I don't see a way to do that without the solution being an amalgam of far too many parts.

Medicare for all is that it has one management. It covers everyone, not people in various categories for which they qualify. It frees corporations. It doesn't doubletax employees who have corporate insurance. It includes those employees who have coverage, who tend to be higher income. Such a state plan would have conflicting direction and laws imposed at the federal level - presenting more than just a management problem.

So, how long would you leave families without care before they are covered?

And, surely a state by state patchwork would lead to a regression to the bottom as states attempt to drive their sick onto other states through pricing and other rules. Plus, low population states would find themselves far less capable of withstanding variation in healthcare needs. CA can have a good concept of an average cost. Wyoming, Vermont, Washington DC have a far smaller budget and variability would be a larger risk. Also, DC has a budget that must pass the federal House!! They can't even make their own decisions!

I do understand the desireability of having an experiment. I just don't believe a half assed solution actually proves anything. In fact, I think the experiments of the many other countries does a better job of that.

 

- you're pointing to ridiculous hypotheticals when actuals exist. You can already see exactly what our government is willing to do for the aged.

- I think you're ignoring that most countries allow individuals to buy for-profit insurance to augment their care if they want to.

 

One thing I've noticed, Will, is that different politicians have a different definitions of "Medicare for All" or "Universal Health Care". So it makes it confusing when talking about it.

So is it comprehensive, unrestricted health care that is free at the point of service? Or ...
Is it a blend of government funding and private insurance? Or ...
Or is it simply our present day Medicare program expanded to everyone?
Is it free at the point of service, or are there deductibles and yearly maximum out-of-pocket costs?

So as a trial balloon, why not just take care of our parents and grandparents? From a political standpoint, how can you argue against that?

And let's just pay for it. Higher payroll taxes, higher income taxes - whatever - but pay for it.

If we are all too damn Scrooge-like to take care of them, the Left can absolutely forget about ever passing a UHC program that covers everyone. It will never happen. Those seniors use up 31 percent of total health spending in this country. Wait until they try to add the other 69% into our taxes. People, including rich liberals, will freak out, and it will not happen.

 

It's not hard. The actual cost of Medicare for a 65 year old is readily available as is the cost of insurance under Obama care (Private insurance). Just compare the two.

 

Is universal healthcare tantamount to "Medicare for all?"

If so, I don't think Bernie's plane will materialize.

 

I absolutely agree that talking about this is hard, because there are multiple final solutions as well as intermediate steps being proposed as "Medicare for all". It's really hard to always know what people are proposing.

We're not really in a society where it's acceptable to let the aged suffer for not having adequate numbers of surviving children.

 

I agree it won't materialize in one step.

First of all, anything we do is going to be designed by congress.

And, like with Obamacare, what they do is going to be incremental.

 

Could be. Kinda like the frog in the pan of water where the heat is turned up incrementally.

 

Things are changing rapidly, and you might be surprised to find out that we really don't have a problem with letting people deal with life as best they can.

For people who didn't have enough children, well they chose that lifestyle because raising kids isn't easy. It's expensive, time consuming, and a choice that people make. Now that they're old, well... they have a few more years left to ponder the reasons and repercussions for their life choices on their own.

 

We absolutely do need change. We know the water is plenty hot and is not cooling.

There are sound reasons for making incremental rather than wholesale change.

I think the idea of growing our Medicare system is a good approach idea, as it is working today.

However, it does miss on some important issues. For example, it doesn't free corporations from having to design and manage healthcare plans, enrollment, etc.

 

Also, children die, move to other countries, etc.

I'm not really ready to give the FU to parents of children lost in school shootings, etc.

Plus, you may not be aware that some children don't get wealthy enough to pay the healthcare costs of aging parents while raising their own families.

 

My understanding of the bill is that it does eliminate private insurance in the state, so I'm not sure what you are referring to about double charging people who have corporate coverage. There wouldn't be corporate coverage. Isn't that what you want, to get rid of private healthcare?