"Who's gonna pay for Medicare for all?" is either stupid or disingenuous

They are interested in measuring market share. Sure.

However, that is a factor in determining a strategy to maximize PROFIT.

Market share is NOT the primary objective of public for profit corporations such as healthcare insurance companies.

 

This is total nonsense, top to bottom.

People who are impacted absolutely do include those who work full time or MORE - at least while they are healthy.

Notice that healthcare costs are a significant reason for bankruptcy.

And, remember that there are those who have issues over which they have no control, but which preclude them from making enough money to pay insurance companies.

You just aren't thinking this through. Your "tough love" thing is just totally and abjectly disgusting.

Beyond that, we KNOW your idea doesn't work - we've tried it for DECADES!!

Yet, you still think it will work! How much failure do you have to have in order to shake off your nonsense and stand on your own two feet as an American citizen??

 

Yes, there are deadbeats who can afford insurance, but don't bother because they think the er will save them anyway. However, that's nonsense. ERs will cause you to not die. But, they aren't going to help you recuperate and they aren't going to give all the procedures you may need. AND, those who pay will be you and me.

This is why Obamacare required that everyone get covered. Insurance companies pointed this out as a requirement of any healthcare system. If people can get insurance at the time of their first need, insurance isn't really insurance anymore - it becomes no more than a payment schedule.

As for those who "pay their own bills", I'd point out that, uh no, they don't. Those who supposedly pay their own become deadbeats, go bankrupt, pay off at rates that amount to the interest on the bill, etc. And again, you and I pay when we buy insurance - as those hospital charges insurance companies have to pay have indigent services wrapped up in them.

You just THINK you're not paying for them! We can do far better and be far more efficient if we stop lying to ourselves.

 

We really don't need to look any further than Medicare to see a savings of about 30% with better coverage.

 

Competition is based on gaining market share at a profit margin per the business plan. The goal is to maximize profits by increasing market share. And the important correlary is that there must be a quality product offered. Government provided has no incentive to provide a quality product but there is an incentive to grow a huge bureaucracy which is exactly what has happened in the UK.

 

The “uninsured” pay ~ half of there medical bills. Private insurance premiums are ~ 3% higher to cover this. A much higher percentage (some estimates are as high as 30%) of private premiums cover shotfalls in Medicare and Medicaid.

 

That's a fair amount of BS.
If it were true we would be better off without them.

 

The US would be better off without them.

 

Another ridiculous statement. Are you saying health insurance companies don't tell you what they will pay for and how much they will pay? I worked for 45 years outside of the 3 years I spent in uniform. Every health insurance company I ever had limited and determined what they would pay for and how much they would pay.

Go tell your doctor you feel aches all over and tell him you want a full body scan. Tell your doctor that you want that treatment for pancreatic cancer that Alex Trabec is getting that costs close to a mill. or that you want to go to John Hopkins or Mass General or such for your surgery.

Other nations don't pay doctors for the number of tests that they perform and they are not allowed to own the equipment for which they order tests. They don't have hospital rooms that are like hotels. 6 years ago I had a stent installed, the room had a 40"screen and was bigger than my own bedroom in walk around room. Nice chairs etc. There was no need for that and I could have easily been in a room with a couple of other men with non contagious illnesses. There must have been 10 RNs at each shift at the nurses station. Cut that in half and put CNAs on the floor. Allow patients to administer thier own medicine from a pharmacy and not send a CNA 1/2 mile away to a central store room to give you a tylenol or blood pressure medicine in a cup at a cost of $18 four times a day.

Every doctor spends 20% of his day filling forms for insurance companies. Every insurance compnay has different forms and criteria to be met before they accept a bill. Even without medicare for all, just use the medicare forms and justifications and every doctor would save 1 hour a day and could see 3 more patients and get paid for those three patients too or heaven forbid have dinner home with his family.

 

The incentive to take care for yourself is diminished because you have private care or group care? I now get 90% of my healthcare through the VA, because it is free when I go there 2x a year I take care of myself less? Now we are not talking hypochondriacs or what ever but 95% of us. Everybody knows that person at work that goes to the doctor for sniffles even when it cost them 25$ for a co-pay but those people are few.

Whether you are paying a tax or a premium has no bearing on how often you would seek service. Medicaid patients don't seek service any more often that private sector with the same health conditions. Edit, with the exception of emergency room visits as there pool of doctors is more limited.

 

Only Bernie has been honest about it and during the last debate he stated what we all know clearly that the required increase in taxes will outstrip the reductions to the employee and employer.

 

What do you mean out strip the reductions? Before I retired, I made 90K and my benefit package was broken down so that I may choose, I forget the exact figures but is was something like 7,000 for vacation, 10,000 for healthcare (EMPLOYER CONTRIBUTION ONLY), 1000 for wage continuation and so on. So your saying that my family's tax bill would rise more than 10,000 grand? From what I read, I thought my taxes would go from 22% on the 55,000 of taxable income to 29% percent a 7% tax rate increase. for me to pay 10,000 plus my premium part of 5000 is 15,000 minus 22% pre tax is say 12,000 grand. if you average the the 12 and 22 percent tax brackets for the 55,000 you get 9900 tax burden, Instead you say I will now pay almost 22,000 in tax on a 55,000 income, I find that hard to believe. I only made about 40% more than the average family. My thought was that his plan raised taxes on everyone 7%.

20 trill of total income (2020 est) would raise 1.4 trill more- private healthcare now pays 2 trill a year of which 20% goes to overhead and profits and not to providers so that is 1.6 trill. Maybe Bernie thinks that there is 10% savings in going to one set of billing standards.

by these calculations instead of paying 12,000 for my heatlh care out of (after 20% pretax)
I would pay 6,300 (90Kx7%) plus my present 9,900 tax burden or about 15.5K a year instead of the 9,900 tax and 12,000 premium that I paid before so a 6,500 dollar savings.
and since I am in the top 30% percent of wage earners the other 70% would see greater savings.

 

I agree that those who prefer to have private health insurance should be free to seek a private insurer willing to provide coverage to their families, with any pre-existing exclusions the insurer may require, without any subsidies, at whatever cost they can negotiate. The insurer's bottom-line bureaucrats can dictate courses of treatment and procedures they may or may not choose to cover. That is capitalism.

Give all Americans the choice of opting for an inclusive plan that eliminates all the added cost of profit margins, astronomical executive salaries, payrolls, agency commissions, repeated duplication of all bureaucratic functions. Eliminate the government's demanding that private businesses allocate their time and resources to administering healthcare plans, and free them to direct their unimpeded attention to the requirements of their particular businesses. That is capitalism.

As a purely practical matter, you have all advanced, democratic nations providing quality healthcare for all at a far lower cost than the US - actually achieving Fake Don's promise of "something terrific!" that covers "everybody!" at "less cost!" Meanwhile, in the US, the millions uninsured have their medical expenses routinely dumped on the American taxpayer.

Besides the empirical data that confirms Fake Don's vision is achievable, the United States has already in place and working, a system of universal coverage of all Americans over 65 years of age, over 60,000,000 people. The reason that insurers do not regard this demographic as a profitable market is that it is the one of highest risk.

Incorporating lower-risk demographics into that risk pool would, obviously, reduce the cost of healthcare for each and every American even further, while eliminating the need for the American taxpayer to cover the expenses of the millions now uninsured - millions more under Fake Don, under whom healthcare costs continue to soar.

Fanatical ideologue will never accept the demonstrably superior, pragmatic paradigm that realizes Fake Don's state goal, and the profiteers who feed off the inefficiency of the current, unsustainable plight will allocate their considerable resources to thwarting progress, but Fake Don's vision of a system that is "something terrific!" that covers "everybody!" at "less cost!" is a reality in advanced, democratic, capitalistic nations, and there is no reason to believe the US is incapable of achieving it as well.

 

They pay to the extent that premiums paid cover procedures based on the policies purchased. Governments limit total spending per what is budgeted.

Doctors in the US practice defensive medicine due to unreasonable medical malpractice laws. Estimates of this spending are as high as $600B per year.

Doctors don't spend 20% of their time filling out insurance forms.

Your suggestions above are to ration care. That's what governments do.

 

Medicare is subsidized by those who have private health insurance. It would be a far better system if insurance vouchers were provided those over 65 to purchase the type of insurance they actually want. That would also help reduce the national debt.

 

All those who pay now will continue to pay, the total paid will just be less and those served will be increased.
The math is available on the 'net. France, for example, spends little more than half per capita than the U.S. and has a healthcare system objectively rated as among the best in the world.

 

All employer-administered plans are subsidized. Everyone covered under an employer-administered plan is being subsidized by the taxpayer.

The reality is that Medicare is far too successful for ideologues to destroy. There is no reason to pretend that incorporating lower-risk demographics into the risk pool would not substantially lower the highly-inflated costs that Americans now must pay. That is an actuarial certitude.

There are multiple practical, proven pragmatic examples of the superior paradigm that achieve Trump's goal: quality care for all at far lower cost.

The National Debt officially topped $22 trillion, marking a $2 trillion increase since Fake Don took office. Lowering it does not appear to be of much interest to him.

 

That’s because during WWII employer provided healthcare insurance premiums were made tax expenditures.

Medicare for all would be a disaster for the US.

 

Middle class taxpayers would pay for this. France rations health care.

 

Medicare for 60,000,000 Americans has not been a disaster for the US.

Freeing lower-risk demographics to opt into it if they so choose would lower the cost.

(The largest tax subsidy for private health insurance — the exclusion from income and payroll taxes of employer and employee contributions for employer-sponsored insurance (ESI) – was estimated to cost approximately $250 billion in lost federal tax revenue in 2013.)

 

What diff is there between economic rationing (ability to purchase gold standard policies like what congress has) and government allocation of funds. If a thousand people need a treatment that costs 1000 dollars and the government only has 900K, 100 people would not receive treatment, they would just pay 900 each.

As far as paper work per Forbes you know that super liberal left leaning group!
https://www.forbes.com/sites/brucel...s-of-their-time-doing-paperwork/#724d72f75d7b

The only reason for 1/2 thier paperwork is insurance billing, Think about this, Blue cross you figure same testing parameters for everything, wrong, PPO are one set, HMOs are another set, fee for service a different set of criteria to meet, then throw in every office has one girl that pretty much just does billing, so that is 50,000 grand a year wages an benefits
My old cardiologist office consisting of 5 doctors and 2 nurse practitioners had 2 women who just did billing. 1 would do 1/2 the insurance companies and the other would do the other 1/2. I had a friend who worked for an oxygen supply company in billing, they had is set up the same way. not by patient illness, or alphabetical, or chrono, but by insurance company.

As far as def medicine, if the government does not allow the test, how is the doctor liable?
The doctor tells the patient, hey in 1% of cases this can happen, a test for this would be 100 bucks, do you want the test? While some of the tests that doctors perform is related to def medicine, most are related to the fact they they can bill for them. that is why I would have it like in the EU or Canada or Australia where doctors can not own or profit (kickback referrals) from testing facilities.

 

What the hell makes you think it should be free?
IF you are paying for it, then you are free to give it away. When you give away what others must pay for, you are stealing from them. Since you certainly don't want to be a thief, just give your paycheck to the local medical association and tell them to help anyone who comes in until it's gone. Then, you can feel that you have done your good deed, made it unnecessary for someone else to stand on their own feet and are therefore righteous.

Unhealthy behaviors are behind the bulk of medical costs. Obesity is rampant. Bad eating habits result in heart disease and many other issues. Smoking, drugs, carelessness in the use of chemicals and the like cause the majority of cancers. WE are the cause of most of our own diseases and maladies. WE have the power to change that for ourselves- IF we choose, and IF we have the motivation.

We are motivated to change by the consequences of our own actions. That may be painful, and it may be fatal- but it is what causes us to change our habits and choices. When the consequences fall on others, or others prevent the consequences of a person's own choices from falling on them- they don't learn a damn thing except that they don't need to change, and we don't change a damn thing. Those who live their as parasites, be it via health care, food stamps, welfare- do so ONLY because you make it possible. You allow what was designed to be a hand-up to help people get back on their feet into a lifestyle, and a hand-out.
That is degradation of character spirit, and the ability to respect yourself. That is the part of the "gift" of inappropriate help.

I believe your perception here needs to step up to a higher plane and the view of the bigger picture.

The world is mostly populated with species that have thrived for millions of years, without government, healthcare, psychologists, cops, lawyers, prisons- and they have done that without poisoning the planet, or consuming all the natural resources, or steadily causing the extinction of others. The big and small, weak and strong have thrived side by side, and every one of them can do what no human can do- survive and thrive with nothing more than what nature gave it. The fact that humans came along and have nearly destroyed all that should make it obvious that we can't manage anything- especially ourselves.
Nature knows how to make life work. All the species on earth know how to make life work. Except- Humans. We haven't a clue and are burning up all the success of those millions of species trying to learn to figure it out. Maybe a wise man would look to nature's other species who have done so well, and ask, "What to they know that we don't know?"

None of those millions of thriving species have ever had health insurance. Why haven't they died off before we got here? Why are so many of them, despite the misery humanity has imposed on them, still thriving? Because they know and understand what you do not.

 

That’s because Medicare is subsidized by private insurance premiums.

$22T in national debt is not a disaster ??

 

How does a healthcare consumer sue the US government for malpractice ??

You actually believe there will be less paperwork if the government takes over healthcare ??? Look at the NHS in the UK.

 

Why do you claim that, and how do believe that corresponds to the largest tax subsidy for private health insurance being the exclusion from income and payroll taxes of employer and employee contributions for employer-sponsored insurance plans - estimated to cost approximately $250 billion annually?

Given that advanced, democratic nations have actually achieved Trump's stated goal of covering everybody at less cost, why prevent Americans in the lower-risk demographics from joining the 60,000,000 now covered by Medicare?