Medicare For All

[highfigh]

The health insurance industry profits are nowhere near high enough to support your assertion above. In 2018 profits were $23.4B. That's a lot, but not compared to national healthcare costs.

https://naic.org/documents/topic_insurance_industry_snapshots_2018_health_ins_ind_report.pdf

From that link-

"However, net premium revenues have increased at a higher rate than total hospital and medical benefits. The spread between earned premium and total hospital and medical benefits has increased to $110.2 billion in 2018 from $61.5 billion in 2013. "

 

[GO-NAD!]

For me, it's simple. Real simple.

All I want is to be able to go to any doctor of my choice, get examinations done, get testing done, get procedures done, get surgery done and not have to worry about how all of this is going to be paid for. High deductibles, co-pays, high out of pocket limits, denial of coverage, you name it.

I'm not a fanboy of any politician. Really, I'm not. It's just that some politicians are waving the health care reform flag as a priority and some are not. I tend to listen to the health care flag wavers a little more over the ones that won't talk about it or even reveal their tax returns.

As a citizen of a country with a universal, publicly-funded, health care system, I can tell you that it isn't a panacea. It doesn't resolve all health care problems. Although health care costs are drastically lower in Canada, there are trade-offs. This Wikipedia entry provides a pretty good comparison between the two systems:
https://en.wikipedia.org/wiki/Comparison_of_the_healthcare_systems_in_Canada_and_the_United_States

I don't know if this is much of an issue in the US, but it certainly is in Canada - wait times. One way of controlling costs is to ration care. For example, a few years ago, my wife needed an MRI on her jaw. Since it wasn't considered an emergency, she would have to wait about a year to get it. So, she went to a private clinic to get it done, at a cost of about C$1000. Since this is a service (nominally) provided by the public system, our private insurance is not permitted to cover this cost, so it came out of our pocket.

But, make no mistake, if you require urgent serious treatment, i.e. cancer, emergency surgery, life-threatening infection, etc, you WILL get it and right away. And, that care will be the same top-notch quality no matter your economic status. My family has private coverage from two insurance providers - one, as a result of being a retired military member and the other through my current employer. This coverage is for items not covered by the public system - prescription drugs, vision, dental, etc. The premiums and deductibles are quite low, because family doctor and hospital care a paid for by the public system.

I broke my arm at the wrist a couple of weeks ago, due to a slip and fall. I went to a comprehensive health clinic near home, where they set my arm in a cast. Because it isn't an all-encompassing hospital, they had to send the post-casting x-ray to the orthopedics dept at the hospital downtown for their blessing. Well, they didn't like the positioning of my wrist, so I had to go to the hospital to have it reset.

Because it would be rather painful to have the first cast removed and resetting my arm was - in his words - "going to be a bit more violent", the orthopedic resident said I would need to go under conscious sedation. When I came back to my senses, the first one was gone and a new rather club-like gargantuan thing had replaced it. The doc said it had to be that way to maintain the positioning of my wrist and he was still concerned it might require surgery. He said he would discuss it with the orthopedic surgeon the following day to get his opinion. in the end, I didn't require surgery. I saw the surgeon a week later and after an x-ray, he said he was happy with how it was progressing. I saw him again this past Tuesday and, after another x-ray, he said I could get a lighter cast put on. Being keen to get rid of my club, I said yes. However, this being done under the public system, the government only pays for a plaster cast. I had to pay the pharmacy imbedded in the hospital C$17 for the cost of the fibreglass, which I was happy to do.

Other than the cost of the fibreglass, there was no other bill to pay and no insurance forms to deal with. For all its faults, I'm glad we have publically funded universal health care. All developed nations should have this, by default. Nobody should be heading for the hospital wondering how much their care was going to cost them.

But, I think the Democrats' might be a bit too ambitious. If they want any chance of getting there, they might have to make the process more gradual and perhaps not as comprehensive.

 

[Out-Of-Phase]

For all its faults, I'm glad we have publically funded universal health care. All developed nations should have this, by default. Nobody should be heading for the hospital wondering how much their care was going to cost them.

That says it all. Thank you for your support GO-NAD!

 

[highfigh]

As a citizen of a country with a universal, publicly-funded, health care system, I can tell you that it isn't a panacea. It doesn't resolve all health care problems. Although health care costs are drastically lower in Canada, there are trade-offs. This Wikipedia entry provides a pretty good comparison between the two systems:
https://en.wikipedia.org/wiki/Comparison_of_the_healthcare_systems_in_Canada_and_the_United_States

I don't know if this is much of an issue in the US, but it certainly is in Canada - wait times. One way of controlling costs is to ration care. For example, a few years ago, my wife needed an MRI on her jaw. Since it wasn't considered an emergency, she would have to wait about a year to get it. So, she went to a private clinic to get it done, at a cost of about C$1000. Since this is a service (nominally) provided by the public system, our private insurance is not permitted to cover this cost, so it came out of our pocket.

But, make no mistake, if you require urgent serious treatment, i.e. cancer, emergency surgery, life-threatening infection, etc, you WILL get it and right away. And, that care will be the same top-notch quality no matter your economic status. My family has private coverage from two insurance providers - one, as a result of being a retired military member and the other through my current employer. This coverage is for items not covered by the public system - prescription drugs, vision, dental, etc. The premiums and deductibles are quite low, because family doctor and hospital care a paid for by the public system.

I broke my arm at the wrist a couple of weeks ago, due to a slip and fall. I went to a comprehensive health clinic near home, where they set my arm in a cast. Because it isn't an all-encompassing hospital, they had to send the post-casting x-ray to the orthopedics dept at the hospital downtown for their blessing. Well, they didn't like the positioning of my wrist, so I had to go to the hospital to have it reset.

Because it would be rather painful to have the first cast removed and resetting my arm was - in his words - "going to be a bit more violent", the orthopedic resident said I would need to go under conscious sedation. When I came back to my senses, the first one was gone and a new rather club-like gargantuan thing had replaced it. The doc said it had to be that way to maintain the positioning of my wrist and he was still concerned it might require surgery. He said he would discuss it with the orthopedic surgeon the following day to get his opinion. in the end, I didn't require surgery. I saw the surgeon a week later and after an x-ray, he said he was happy with how it was progressing. I saw him again this past Tuesday and, after another x-ray, he said I could get a lighter cast put on. Being keen to get rid of my club, I said yes. However, this being done under the public system, the government only pays for a plaster cast. I had to pay the pharmacy imbedded in the hospital C$17 for the cost of the fibreglass, which I was happy to do.

Other than the cost of the fibreglass, there was no other bill to pay and no insurance forms to deal with. For all its faults, I'm glad we have publically funded universal health care. All developed nations should have this, by default. Nobody should be heading for the hospital wondering how much their care was going to cost them.

But, I think the Democrats' might be a bit too ambitious. If they want any chance of getting there, they might have to make the process more gradual and perhaps not as comprehensive.

The problem here is in how the proposed plans will be funded- we have over 45% of the working population not paying any income tax, so it's totally different from what most of the rest of the World would have to deal with. They're going after the low-hanging fruit by vilifying the wealthy for keeping their money and I'm not sure class warfare has ever been worse. Another huge problem here is in how the government screws up just about every program it creates- they just can't stop wasting money and being inefficient. If Canada could manage the program, we might have something but with our Congress, my fear is that they'll appoint some crew of all stars to control it and it will start out as crap and turn into crap².

 

[Irvrobinson]

Another huge problem here is in how the government screws up just about every program it creates- they just can't stop wasting money and being inefficient.

Exactly. Let's take, for example, the Department of Education, one of my least favorite wastes of money. $60B, down from $68B in 2016, and even when I look at internet searches for what they do and accomplish I can't figure out anything tangible, especially given the sorry state of education in the US.

Medicare + Medicaid already cost about $1T and covers about 37% of the US population, and less total coverage than Medicare-For-All. Imagine the administration that covers everyone? All of made up of employees who are very difficult to performance manage or terminate, and have constitutional rights at work.

 

[Irvrobinson]

From that link-

"However, net premium revenues have increased at a higher rate than total hospital and medical benefits. The spread between earned premium and total hospital and medical benefits has increased to $110.2 billion in 2018 from $61.5 billion in 2013. "

I saw that, but I'm not sure what it means. I was focusing on Figure 1, net profits. 3.3% isn't horrible, but it's lower than most other services industries. That said, I'm not fond of insurance companies either.

My auto insurance company sent me a survey about "how they're doing". In the comments section I wrote: "So far I'm the perfect customer, you've taken a considerable sum of my money and I've taken none of yours. When it's my turn to take some of your money I'll let you know how you're doing."

 

[GO-NAD!]

The problem here is in how the proposed plans will be funded- we have over 45% of the working population not paying any income tax, so it's totally different from what most of the rest of the World would have to deal with. They're going after the low-hanging fruit by vilifying the wealthy for keeping their money and I'm not sure class warfare has ever been worse. Another huge problem here is in how the government screws up just about every program it creates- they just can't stop wasting money and being inefficient. If Canada could manage the program, we might have something but with our Congress, my fear is that they'll appoint some crew of all stars to control it and it will start out as crap and turn into crap².

Well, 40% of Canadians pay no income taxes, as well. I don't have a problem helping people with low incomes access the same level of health care that I have. It's one of the costs of a harmonious society.

Trudeau is right: 40% of Canadians don’t pay income taxes, which means someone else is picking up the bill

Ted Rechtshaffen: The top 20 per cent is likely paying 70 per cent or more of all income taxes

business.financialpost.com

But, I get your point, since our system costs much less than yours. That said, the US government isn't unique regarding waste and inefficiency. I get the sense that the ever increasing polarization in the American political sphere drives each party to ever more irrational policies - the Democrats with their pie-in-the-sky health care, educational and environmental policies vs the Republican tax cuts driving up the deficit and dismantling of environmental regulations.

 

[Irvrobinson]

An awesome quote from this morning's Wall Street Journal, in an opinion piece: "Ms. Warren should be commended for the wealth of detail in her plan, which allows voters to judge it for themselves. That said, she may well have just penned the longest suicide note in recorded history."

 

[panteragstk]

The best opinion I've read yet about Medicare-For-All, from a Democrat, Rahm Emanuel.

https://www.washingtonpost.com/opinions/someone-needs-to-say-it-medicare-for-all-is-a-pipe-dream/2019/10/25/b4b6a17e-f764-11e9-8cf0-4cc99f74d127_story.html

IMHO this is what bugs me about medicare for all. From the linked article.

I’m mystified as to why, at a moment when 90 percent of Americans already have insurance, our presidential debates are focused so exclusively on expanding coverage rather than containing costs.

This is the actual issue, not getting free healthcare (it won't be free btw, but god forbid anyone actually understand that). Costs are too high overall. If they manage to get the costs down to a reasonable level while maintaining companies ability to research and progress, then that's the actual solution. Not get someone else to cover the same high costs. That logic just doesn't work.

 

[Out-Of-Phase]

"The Democrats are pushing for Universal HealthCare while thousands of people are marching in the UK because their U system is going broke and not working. Dems want to greatly raise taxes for really bad and non-personal medical care. No thanks!"

— Donald J. Trump (@realDonaldTrump) February 5, 2018

The People’s Assembly and Health Campaigns Together response:

"Dear Donald Trump

The NHS has existed since 1948 in the UK after the devastation of the second world war. The British population demanded the right to have access to healthcare which they deserve as human beings which is absolutely affordable when the right political decisions are made.

It has been a shining example to the world of what can be achieved when we put the needs of the collective good over the interests of a few wealthy individuals. Unfortunately, our current government have been persuaded to increasingly adopt policies which represent those of your Government, they have decided to move us more to an American-style system which is widely acknowledged to be one of the most expensive, inefficient and unjust healthcare systems in the world.

This is why our NHS is currently struggling and why leading Professors including Professor Stephen Hawking are bravely battling politicians who wish to turn it into a system like yours.

This is what our demonstration was about on Saturday 3rd Feb and tens of thousands of British people want to show their love for the principles of universal and comprehensive care free at the point of use, paid for through general taxation. We don’t agree with your divisive and incorrect rhetoric. No thanks."

 

[highfigh]

Well, 40% of Canadians pay no income taxes, as well. I don't have a problem helping people with low incomes access the same level of health care that I have. It's one of the costs of a harmonious society.

Trudeau is right: 40% of Canadians don’t pay income taxes, which means someone else is picking up the bill

Ted Rechtshaffen: The top 20 per cent is likely paying 70 per cent or more of all income taxes

business.financialpost.com

But, I get your point, since our system costs much less than yours. That said, the US government isn't unique regarding waste and inefficiency. I get the sense that the ever increasing polarization in the American political sphere drives each party to ever more irrational policies - the Democrats with their pie-in-the-sky health care, educational and environmental policies vs the Republican tax cuts driving up the deficit and dismantling of environmental regulations.

Did Trudeau take a lot of crap for the comment about the 40% who don't pay income tax? A similar comment is a big reason Mitt Romney for him being eliminated as a POTUS contender. Well, along with other comments people hated. The entire Canadian population is smaller than the number of non-payers in the US. Look at the problems in California and think about the fact that they have more people in that one state than in all of Canada. Their state budget shortfall is almost four times that of Canada's deficit.

I would bet that the cost of US law enforcement alone would break the Canadian economy. People are going nuts here, on local levels and when they move from state to state, the burden increases on the larger scale. Trying to get people to pay more for federal programs is a hard sell.

 

[highfigh]

I saw that, but I'm not sure what it means. I was focusing on Figure 1, net profits. 3.3% isn't horrible, but it's lower than most other services industries. That said, I'm not fond of insurance companies either.

My auto insurance company sent me a survey about "how they're doing". In the comments section I wrote: "So far I'm the perfect customer, you've taken a considerable sum of my money and I've taken none of yours. When it's my turn to take some of your money I'll let you know how you're doing."

My business insurance company insisted that I use direct deposit for my premiums and in this calendar year, those payments failed because my bank or a payer's didn't process some payments quickly. They dumped me, even though I have had exactly zero claims and yes, I received an e-mail with a survey, asking how they're doing.

To say that I'm not a fan of insurance would be the understatement of the Modern Epoch.

I was talking about insurance with a friend at a club where a mutual friend was playing and at one point, I said "Now watch- I'll walk outside and my car will be gone". Yup.

 

[GO-NAD!]

Did Trudeau take a lot of crap for the comment about the 40% who don't pay income tax? A similar comment is a big reason Mitt Romney for him being eliminated as a POTUS contender. Well, along with other comments people hated. The entire Canadian population is smaller than the number of non-payers in the US. Look at the problems in California and think about the fact that they have more people in that one state than in all of Canada. Their state budget shortfall is almost four times that of Canada's deficit.

I would bet that the cost of US law enforcement alone would break the Canadian economy. People are going nuts here, on local levels and when they move from state to state, the burden increases on the larger scale. Trying to get people to pay more for federal programs is a hard sell.

I believe he was criticized a bit, but obviously not enough to lose the last election - although he lost his majority and now has a minority government.

I believe you on the law enforcement thing. You have more agencies than you can shake a dozen sticks at.

 

[GO-NAD!]

My business insurance company insisted that I use direct deposit for my premiums and in this calendar year, those payments failed because my bank or a payer's didn't process some payments quickly. They dumped me, even though I have had exactly zero claims and yes, I received an e-mail with a survey, asking how they're doing.

To say that I'm not a fan of insurance would be the understatement of the Modern Epoch.

I was talking about insurance with a friend at a club where a mutual friend was playing and at one point, I said "Now watch- I'll walk outside and my car will be gone". Yup.

Yeah, insurance is a friggin' racket, I tell ya. Our problem is with our private health insurance providers. My wife takes care of all our claims and I'm very glad for that. They're just for relatively low dollar amounts, since they're for some run-of-the-mill prescription meds, wife's massage therapy, etc. But, they can find a way to shag up practically every claim. I don't know what their problem is, but it looks like every person processing each claim has just been hired off the street. I don't know how many claims she's had to resubmit, covered in post-it notes pointing out where they've eff'ed it up and correcting the math. The cynic in me thinks it's all deliberate, in hopes you'll accept the low-balled amounts and go away. They clearly don't know my wife.

 

[highfigh]

I believe he was criticized a bit, but obviously not enough to lose the last election - although he lost his majority and now has a minority government.

I believe you on the law enforcement thing. You have more agencies than you can shake a dozen sticks at.

Better be careful about mentioning sticks- the Department of Natural Resources will probably request a license for that.

 

[Irvrobinson]

A rare balanced and well-written article from NBC News:

Doctors, hospitals take up arms against Democrats' health care changes

The debate over various "Medicare for All" plans has gripped the presidential primary contest.

www.nbcnews.com

 

[herbu]

For me, it's simple. Real simple.

All I want is...

Why should other people care or pay for, "what you want"?
Healthcare is a "right". Really? Bestowed by whom?
Why should charity health services provide the very best treatment? (Do they serve filet mignon at the shelter?)

The benefits I receive from Medicare are a result of my payments for 50 years. And, BTW, when you turn 65 you are required by law to sign up for Medicare. Signing up is not "hypocrisy".

Everybody feels compassion for the less fortunate. Everybody wants to help. But charity cases don't get ANYTHING as nice as rich people. If you tell me you donate more/better than what you keep, I'll doubt your integrity. Healthcare is no different.

 

[Mikado463]

And, BTW, when you turn 65 you are required by law to sign up for Medicare. Signing up is not "hypocrisy".

not completely true, for one if you're still employed and covered under your employers plan which has an HSA you CANNOT be signed up for Medicare and contribute to an HSA.

Also, things are a bit different under Railroad Retirement. So be careful when you talk in generalities ......

 

[Out-Of-Phase]

"Last year, 36 million Americans didn’t have a prescription filled because they couldn’t afford it."

Elizabeth Warren on Thursday, December 19th, 2019 in comments made during the December Democratic presidential primary debate.

 

[Irvrobinson]

"Last year, 36 million Americans didn’t have a prescription filled because they couldn’t afford it."

Elizabeth Warren on Thursday, December 19th, 2019 in comments made during the December Democratic presidential primary debate.

Yeah, but which prescriptions? Insulin? Some were, that's for sure. But how many are in this category?

Death by Prescription

Has our stressed-out, multi-tasking, anxiety-causing way of life turned us into a nation of addicts? Are we seeking out doctors who don't mind giving us multiple prescriptions for every little ache and pain and angst?

www.huffpost.com

Figures of merit to characterize complex data are useless, and typical of Warren's campaign. I haven't seen a plan from her yet about how if Medicare for All is enacted how she's going to keep wait times reasonable, when all medical care is completely free to everyone. She's lies more about medical care than high-end cable manufacturers do about how power cables sound.