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Author | Topic: Republican Healthcare Plan | |||||||||||||||||||||||||||||||||||||||
Taq Member Posts: 10067 Joined: Member Rating: 5.2
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Cat Sci writes: I've seen the government fuck up enough shit that the last thing that I want them in charge of is my healthcare. But I don't care if they are in charge of your healthcare. In your own posts you are describing how the current corporate run system is fucked up, yet you want to stick with it. You want to stick with a system that is messed up AND pay twice as much for it.
I also don't want to pay more in taxes. And I'd like to keep my healthcare costs reasonable. So now what?
Now you work on realizing how those two wishes are in complete contradiction to each other. Edited by Taq, : No reason given.
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JonF Member (Idle past 193 days) Posts: 6174 Joined: |
Medicare is not that great because you still have to buy additional insurance.
You don't have to buy additional insurance. You can pay out of pocket. You seem to think everybody has enough disposable income. Would you be in favor of making Medicare better by allocating additional government funds to make copays and limits equivalent to private insurance?
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Taq Member Posts: 10067 Joined: Member Rating: 5.2
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Cat Sci writes: My employer pays me a salary and on top of that they pay for my health insurance as a benefit. If I opt out of the benefit, then that money does *not* go on top of my salary. This is why we need better unions in the US. Workers need to band together and negotiate better deals for their compensation. If we do shift from private insurance to single payer, employers absolutely should give you that money as salary.
Medicare also requires supplemental insurance. Now you are complaining that people don't have enough socialist healthcare.
So why would you want them in charge of your healthcare? In a single-payer system, your doctor is in charge of your healthcare just as your doctor is now. The government's role is to figure out how to pay for the treatments that your doctor prescribes.
I'd expect it to be worse with the government... And yet this system works in every other first world nation.
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New Cat's Eye Inactive Member |
In your own posts you are describing how the current corporate run system is fucked up, yet you want to stick with it. I don't want to stick with it, I'm just not convinced that putting the government in charge of it will make it better.
Now you work on realizing how those two wishes are in complete contradiction to each other. Well, sticking with the current system is one way to keep my costs reasonable and not raise my taxes. So there's that. I'm open to other options...
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Taq Member Posts: 10067 Joined: Member Rating: 5.2
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Cat Sci writes: I said that having the government in charge of something makes is more expensive. You responded saying how great Medicare is. Medicare is not that great because you still have to buy additional insurance. Yes, that is the governments fault, but that is more reason why they suck at being in charge of something. I don't see how having to buy supplemental insurance makes Medicare more expensive. One does not relate to the other. What you need to do is add together the cost of Medicare to the supplemental insurance, and then compare that combined cost to what it would cost for private insurance for the same combined coverage. From everything I have read, Medicare patients are charged less for the same procedures compared to people on private insurance. Medicare is less expensive.
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ringo Member (Idle past 437 days) Posts: 20940 From: frozen wasteland Joined:
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Cat Sci writes:
Elect a better government.
I'm open to other options...
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Taq Member Posts: 10067 Joined: Member Rating: 5.2
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Cat Sci writes: I don't want to stick with it, I'm just not convinced that putting the government in charge of it will make it better. The point we are making is that in every other developed country in the world, involving the government has made it better. Apparently, you think the US is so unexceptional that it can't do what every other developed nation has done. The Brits and the French can do it, but the Americans can't?
Well, sticking with the current system is one way to keep my costs reasonable and not raise my taxes. So there's that. They aren't reasonable. We are paying twice what other countries are spending.
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Taq Member Posts: 10067 Joined: Member Rating: 5.2
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Cat Sci writes: Is that not a true statement? Do I need to post the data for per capita healthcare costs for a third time? In ever other developed country where government is involved in healthcare, it is cheaper. So no, it is not a true statement.
And isn't that a different statement than: "Socialist healthcare costs too much."?
No.
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New Cat's Eye Inactive Member |
They aren't reasonable. We are paying twice what other countries are spending. The reasons for our costs being higher includes things that don't have anything to do with how it is payed for. The way America uses its healthcare system, in and of itself, causes it to be more expensive. See Message 80 for some examples. We use higher tech more often, we take twice as many drugs, we're leading the world in research, etc. That is not to say that how it is payed for couldn't help, but it is not the be-all-end-all, and side-by-side comparisons with other countries is not apples-to-apples.
The point we are making is that in every other developed country in the world, involving the government has made it better. Apparently, you think the US is so unexceptional that it can't do what every other developed nation has done. The Brits and the French can do it, but the Americans can't? The Brits and the French don't have the U.S. government. And they pay more taxes. I don't want to pay more taxes. And I don't trust the U.S. government to make it better.
Do I need to post the data for per capita healthcare costs for a third time? In ever other developed country where government is involved in healthcare, it is cheaper. So no, it is not a true statement. I thought you understood that I'm talking about involving the U.S. government. When I say "the government", I mean the U.S. federal government. In general, involving the U.S. federal government makes things more expensive. That is not saying that "social healthcare costs too much".
I don't see how having to buy supplemental insurance makes Medicare more expensive. One does not relate to the other. What you need to do is add together the cost of Medicare to the supplemental insurance, and then compare that combined cost to what it would cost for private insurance for the same combined coverage. That is what I'm talking about: there is the cost of Medicare, and there is the cost of supplemental insurance on top of that.
From everything I have read, Medicare patients are charged less for the same procedures compared to people on private insurance. That's because Medicare decides how much they will pay a doctor for a procedure, rather than the doctor deciding how much to charge the private insurance for a procedure. The doctors effectively take a hit on what they make from a procedure by deciding to accept Medicare. The reason they are willing to do this is because people on Medicare tend to get more procedures in total, so even if they're make less money per procedure, there's more of them to be had to make up for the lower costs per each. So really, the cost per patient can go up even though the cost per procedure goes down.
Medicare is less expensive. Not necessarily.
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NoNukes Inactive Member |
Stop it. I'll do me. You do you. You've already done you. I am just commenting on what you've said. Under a government which imprisons any unjustly, the true place for a just man is also in prison. Thoreau: Civil Disobedience (1846) History will have to record that the greatest tragedy of this period of social transition was not the strident clamor of the bad people, but the appalling silence of the good people. Martin Luther King I never considered a difference of opinion in politics, in religion, in philosophy, as cause for withdrawing from a friend. Thomas Jefferson Seems to me if its clear that certain things that require ancient dates couldn't possibly be true, we are on our way to throwing out all those ancient dates on the basis of the actual evidence. -- Faith
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Taq Member Posts: 10067 Joined: Member Rating: 5.2
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Cat Sci writes: The reasons for our costs being higher includes things that don't have anything to do with how it is payed for. The way America uses its healthcare system, in and of itself, causes it to be more expensive. The way we use healthcare has everything to do with how we pay for it. Those two things are completely tied to one another.
The Brits and the French don't have the U.S. government. And they pay more taxes. I don't want to pay more taxes. And I don't trust the U.S. government to make it better.
Why does it matter if it is tax money? I am still not understand this. If you pay $10k in taxes and $9k on healthcare, wouldn't it make more sense to pay $15k in taxes and nothing else on healthcare? That would be a savings of $4k. Also, just assuming that something will fail when it has worked everywhere else is a really bad argument.
I thought you understood that I'm talking about involving the U.S. government. When I say "the government", I mean the U.S. federal government. In general, involving the U.S. federal government makes things more expensive. That is not saying that "social healthcare costs too much".
You haven't shown that the US federal government makes things more expensive. You have simply asserted it. Guess who pays the least for medications in the US? The VA, a government run hospital. The world has already done the experiment. Universal, single payer systems work. Just asserting that it won't work with nothing to back it up is not a valid argument.
That is what I'm talking about: there is the cost of Medicare, and there is the cost of supplemental insurance on top of that. And what is that total cost? How does it compare to the cost of going 100% private insurance?
That's because Medicare decides how much they will pay a doctor for a procedure, rather than the doctor deciding how much to charge the private insurance for a procedure. The doctors effectively take a hit on what they make from a procedure by deciding to accept Medicare. The reason they are willing to do this is because people on Medicare tend to get more procedures in total, so even if they're make less money per procedure, there's more of them to be had to make up for the lower costs per each. So really, the cost per patient can go up even though the cost per procedure goes down.
The cost per patient is always going to go up with age whether we have private or public systems. Its not as if private insurance will keep people from aging. The simple fact is that Medicare decreases costs compared to private insurance, the very opposite of what you are claiming.
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Modulous Member Posts: 7801 From: Manchester, UK Joined: |
See Message 80 for some examples. We use higher tech more often, we take twice as many drugs, we're leading the world in research, etc. I agree that you have better outcomes for those people whose insurance will cover the higher tech. And while you are all taking like 10 prescriptions a year, your life expectancy averages out to a little under 76 for men, 81 for women. This puts you up there with Chile and China. The UK is at a little under 78 for men and 82 for women. (List of countries by life expectancy - Wikipedia) I'd argue there is a suggestion here that the spending isn't benefiting the health of the people, but the pockets of the corporations.
The Brits and the French don't have the U.S. government. And they pay more taxes. I don't want to pay more taxes. And I don't trust the U.S. government to make it better. Well I have three chronic conditions all of which can escalate to life threatening quickly, and have done for a long time. My annual insurance cost is approximately $2,500, you can now do a reverse calculation to roughly infer my salary assuming I am honest... I pay an additional $350 for my year's supply of medicine (two of them are prohibitively expensive to buy) . That's my entire medical bill for all non dental work (I pay privately for dental, but regularly utilize the discounted/free rates of the NHS for routine stuff). I get free eye tests, discounts on glasses and a host of other things. I've had to go to the hospital for emergency care about half a dozen times in the last 5 years and this has cost me an additional $0. My employer contributes $2,700 a year into the kitty. I believe USA citizens pay somewhere closer to $8-9K a year on average? The best part is that this deduction comes out of my wage, so I don't even 'feel' like I'm paying for it. It's a cost that has always been there for me. When I joined EvC my insurance costs were about $600 (present day) a year, because I was earning much less and I didn't have any prescription costs.
That's because Medicare decides how much they will pay a doctor for a procedure, rather than the doctor deciding how much to charge the private insurance for a procedure. Well, no. Otherwise Medicare would decide 0 and the doctors would decide infinite. In both cases the hospital administration charges as much as it can and Medicare and the private insurance companies try to pay as little as they can. Thus market forces are determining price. Medicare has the numbers which gives it a negotiating edge. I believe private insurance agrees to pay for flashy operations and treatments that only marginally improve the patients chances and use agreements with drug companies to promise to give drug companies volume in exchange for price as part of their tools.
So really, the cost per patient can go up even though the cost per procedure goes down. With the NHS, young healthy people that feel immortal still contribute, and if they have high income they are contributing a lot (On 120,000 a year they'd be a healthy person paying about 15,000 a year for national health insurance, their employer would pay about 5700). The numbers are even bigger, the risk even more distributed. Law of large numbers, risk pooling, means tested...This is the optimal solution if you care about people, as it means (the) people's exposure to financial risk is lower allowing more stability and confidence for the future. If you are interested in making it profitable, your system is much better. Your doctors get paid twice as much as ours, for example (it varies but about $70-90K sounds about right for UK doctor salary) which is nice for them. Also, insurance companies make a wonderful little profit. I believe they are even permitted to make an underwriting profit? In the Republican plan, they'd be able to pick their optimal coverage to maximise profit by selectively denying and gouging people of certain groups (aka pay or die). Edited by Modulous, : No reason given.
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New Cat's Eye Inactive Member |
The way we use healthcare has everything to do with how we pay for it. Those two things are completely tied to one another. For instance, even with a single payer system, if you use the emergency room to treat routine belly aches then you are going to drive up costs despite the payment system.
Why does it matter if it is tax money? I am still not understand this. Because that money comes directly out of my pocket.
If you pay $10k in taxes and $9k on healthcare, wouldn't it make more sense to pay $15k in taxes and nothing else on healthcare? That would be a savings of $4k. Yes, that would make sense. But it is not applicable to me because I'm not spending thousands of dollars on healthcare. So any increases in my taxes is a direct cost to me. It doesn't have to be that way, I get it, but that is the way it is.
You haven't shown that the US federal government makes things more expensive. You have simply asserted it. It costs the public sector about a third more to pay a person than it does the private sector. According to the tables here and here, on average, an hour of work costs the private sector $34 and it costs the public sector $45. Additionally:
quote: quote: Guess who pays the least for medications in the US? The VA, a government run hospital. The VAs are the absolutely worst hospitals in this country and the way vets have been treated by them should be a crime. If the VAs are any indication of what government run healthcare would be like then I should be scared for my life of it.
The world has already done the experiment. Universal, single payer systems work. I don't doubt that they can work, I just don't think that one can work well for the U.S. if it is run by our federal government.
And what is that total cost? How does it compare to the cost of going 100% private insurance? You tell me.
The cost per patient is always going to go up with age whether we have private or public systems. Its not as if private insurance will keep people from aging. The simple fact is that Medicare decreases costs compared to private insurance, the very opposite of what you are claiming. The simple fact is that Medicare is capable of dictating to providers what they will be paid for their services. Don't be surprised if the cost per patient for all patients goes up because providers are hedging their loses by increasing the number of procedures and drugs that are "needed".
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Taq Member Posts: 10067 Joined: Member Rating: 5.2 |
Cat Sci writes: For instance, even with a single payer system, if you use the emergency room to treat routine belly aches then you are going to drive up costs despite the payment system. Who goes to the emergency room for a belly ache?
Because that money comes directly out of my pocket. So do insurance premiums, even if your employer is paying for it. That is money they could be paying you. It is still money out of your pocket.
It costs the public sector about a third more to pay a person than it does the private sector. According to the tables here and here, on average, an hour of work costs the private sector $34 and it costs the public sector $45.
The difference is made up for by the fact that no one is taking profit off the top.
The VAs are the absolutely worst hospitals in this country and the way vets have been treated by them should be a crime. More propaganda. Patients at VA hospitals give them the same scores as patients in private hospitals. "The 2013 ACSI index for inpatients recently discharged from a VA acute medical center holds at a strong 84 on a 0-100 scale. This is four points higher than the industry average. The VA outpatient score of 82 is within one point of the industry average."VA Rates High on Patient Satisfaction in National Survey - VAntage Point I don't doubt that they can work, I just don't think that one can work well for the U.S. if it is run by our federal government. Why?
You tell me. You tell me. You are the one claiming that Medicare is more expensive.
The simple fact is that Medicare is capable of dictating to providers what they will be paid for their services. Don't be surprised if the cost per patient for all patients goes up because providers are hedging their loses by increasing the number of procedures and drugs that are "needed".
That would be another example of private providers driving up prices, not the government.
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New Cat's Eye Inactive Member |
Who goes to the emergency room for a belly ache? Stupid Americans...
quote: quote: Bare link: Misuse of emergency rooms: A costly but avoidable error Because that money comes directly out of my pocket.
So do insurance premiums, even if your employer is paying for it. That is money they could be paying you. It is still money out of your pocket. No, we negotiated a salary and then benefits are on top. The benefits do not come out of my pocket. With or without the benefits, my paycheck is the same. Raise taxes and my paycheck goes down.
The difference is made up for by the fact that no one is taking profit off the top. Huh? And what about the other two examples? Are you really trying to stand by the claim that it doesn't cost the government more to do things than it does the private sector?
The VAs are the absolutely worst hospitals in this country and the way vets have been treated by them should be a crime. More propaganda. Patients at VA hospitals give them the same scores as patients in private hospitals. Not propaganda, direct experience. I've worked in VA and non-VA hospitals and they are shit compared to others. One VA was so attrocious that we walked out on them without even starting the service we where there to do for them. It was so filthy that my cowokers and I were not willing to risk our health to do the job. And your score comes from a terribly low sample size. Of the 5,803,890 veterans using VA Health Care in 2013, that survey attempted to contact 1188 of them. 26.5% completed the survey so your sample size ended at 250. 250 people out of 5.8 million... What that tells you is how vets who are willing to complete a survey feel about the VA... The vets I know who hate the VA would hang-up on a survey like that.
You tell me. You are the one claiming that Medicare is more expensive. That's fine. I'll drop the claim. This thread is about the Republican Healthcare Plan.
That would be another example of private providers driving up prices, not the government. Driving up the price in response to the government meddling... Just like people going to the ER for preventable conditions is a response to government meddling.
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