You answered your own question and at the crux of what I've been saying the whooooolllle threadOriginally Posted by David88vert
Make it so that EVERYONE is payed up BEFORE they even walk in the door
You answered your own question and at the crux of what I've been saying the whooooolllle thread
Make it so that EVERYONE is payed up BEFORE they even walk in the door
So, are you saying that if a person is here illegally, or is here on a visa or passport, that they should be denied healthcare? Atourist has a stroke - let him die? A Hispanic person breaks their leg, don't set it until you check to see if he is legal or not?
If someone is here working off the books, how are you going to know if they are paid up before giving them CPR?
Also, what about malpractice insurance? Since doctors will be making less (by your statements), how exactly are they supposed to pay for their insurance premiums? Are those to be backed by the single payer system also, or are you thinking to block all claims of malpractice prior to court filings?
Our current system does not have enough hospital emergency room funding for the needs that they currently have. You think you can reduce those costs without looking at all of the parameters?
"Racing is life. Anything before or after is just waiting." - Steve McQueen
youre dodging the question, or you just dont understand my point. our taxes currently DONT pay for medical care, our PREMIUMS do (which are elective, you dont HAVE to have medical insurance). Premiums rise because of several factors which have been discussed at length.
In order to have a single payer, you would have to raise taxes more than $17000 PER PERSON (NOT FAMILY), including YOU, to BREAK EVEN on CURRENT Medical costs. How else do you pay for it? Medical care costs "X" right now, and "Y" is the revenue used to pay for it.
Covering everyone HAS to be paid for by SOMEONE, then, you can HOPE costs come down because there are more people in the system, but that DOESNT happen, EVER.
HOUSING- Man, lets make houses AFFORDABLE for EVERYONE! Loans go out to anyone with a pulse, housing prices skyrocket, profit, collapse
COllege- Man, education should be AFFORDABLE FOR EVERYONE! loans go out to anyone with a pulse, tuition skyrockets (DESPITE MORE PEOPLE GOING TO COLLEGE THAN EVER), profit, imminent collapse
Green Energy- Man, clean energy should be AFFORDABLE FOR EVERYONE! Loans go out to companies (usually political backers), oil prices skyrocket, green energy gets more expensive, profit, collapse.
SENSE A PATTERN HERE?
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Its the problem with comprehension of the scope of the problem. Single Payer has some positives, but when you look at it from all angles and actually see the scope of making it work, you realize pretty quickly, it just isnt feasible. And every country who has single payer is bankrupt or has worse care than the USA.
His beef is with the insurance agencies in general and how asinine the system is, which, obamacare will do nothing to improve, and in most cases make it worse.
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I still dont have a clue how the govt getting money from marijuana sales is going to lower health care costs. If you are talking about how the govt is going to pay for it, thats a completely different discussion. You said legalized and regulated marijuana would actually lower costs.
Oh and I am still laughing at the fact that you think the govt would have lower overhead than a private sector company. The govt already has a model for what would happen with a single payer. It is called medicare/medicaid. In 2011, Kaiser Permanente collected 47.9B in total revenue. Medicare paid about that much just in fraud.
http://xnet.kp.org/newscenter/annual...e_numbers.html
http://en.wikipedia.org/wiki/Medicare_fraud
Why would I NOT think that medicare's fraud totals wont go up by 10x when 10x the people are added to the scheme? It would probably go up by more than 10x because it would be even easier to commit the fraud because the govt wont be able to hire enough investigators to keep up.
Last edited by BanginJimmy; 03-06-2013 at 04:10 PM.
It's like I'm talking to myself in here cause people keep repeating what I've already addressed.
Emergency care. Burden of the tax payers. Since up front cost has come down, no one comes out really behind.
First, I haven't stated a single time doctors will be making less. I did say that as the system operates right now, (just an example)if its $5000 for all the associated costs for a doctor to remove a bullet from your shoulder, hospitals are charging $15k or more to cover the people that don't pay. If everyone is paying, you can now charge $5000. Right now we are charging patients more to cover the ones that don't pay. If everyone has paid, you've already covered them. I don't think I can simplify that further.Also, what about malpractice insurance? Since doctors will be making less (by your statements), how exactly are they supposed to pay for their insurance premiums? Are those to be backed by the single payer system also, or are you thinking to block all claims of malpractice prior to court filings?
Second, Tort reform.
How do you get everyone to "pay". Again, my numbers prove you cannot tax people enough to pay for healthcare. Explain how that first hurdle gets solved
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Our taxes are paying for poor people who don't have insurance to get treatment. This tax won't go away and instead will get rolled in with the new one.
No one pays any more than what they're paying already, except that more people are now paying into it. The average person pays a premium to the company they work for, the company pays the rest. Instead of that money going to BCBS, it goes to UHS instead, and you see it on your check stub at the end of the week. You make it progressive just like income tax, poor people pay a little less, rich people pay a little more.In order to have a single payer, you would have to raise taxes more than $17000 PER PERSON (NOT FAMILY), including YOU, to BREAK EVEN on CURRENT Medical costs. How else do you pay for it? Medical care costs "X" right now, and "Y" is the revenue used to pay for it.
Those without a job are still on "Medicare", this system doesn't change and instead gets rolled into UHS. You, the worker are still taxed the same for this as well.
Those wanting elective treatments (your "better care") pay the difference. Those that want cosmetic plastic surgery (implants, botox, etc.)pay 100%. Out of pocket.
Tourists and illegal immigrants either pay with the insurance they already have, bill their resident country, bill the patient, or eat it. But now since most citizens are insured, hospitals are eating a lot less.
Housing and college are completely different kinds of markets that Healthcare is not the same and usually stops with the insurance company. There's no transparency in healthcare, and no one does comparison shopping for healthcareHOUSING- Man, lets make houses AFFORDABLE for EVERYONE! Loans go out to anyone with a pulse, housing prices skyrocket, profit, collapse
COllege- Man, education should be AFFORDABLE FOR EVERYONE! loans go out to anyone with a pulse, tuition skyrockets (DESPITE MORE PEOPLE GOING TO COLLEGE THAN EVER), profit, imminent collapse
Green Energy- Man, clean energy should be AFFORDABLE FOR EVERYONE! Loans go out to companies (usually political backers), oil prices skyrocket, green energy gets more expensive, profit, collapse.
SENSE A PATTERN HERE?
You can decide when you want to buy a house, or a car, or go to school. You DON'T decide when you get shot, or get cancer.
So like I said, you want to add 260mil more people to medicare.
Think of it this way. Using 2011 numbers and approximating total rolls to be 6x the current medicare rolls, UHS would cost 3.17T a year.
Of course, you know medicare reimbursement rates will be forced to rise to actually cover the cost of the care. We will call it 10%, which equals another 55B a year using 2011 medicare spending and enrollment, so around 317B more when you add in 260mil more people to the rolls.
Fraud will also rise ~6x, call that another 240B a year in additional spending.
You can also expect 2-300B more a year for the massive bureaucracy that would be created. That bureaucracy would likely also cause docs to raise their rates even more to compensate.
These are all low estimates, especially reimbursement rates, and I would expect the price tag to be FAR higher because anything involved with the govt costs more than it does in the private sector.
BTW, total US spending on health care in 2011 was around 2.9T.
Last edited by BanginJimmy; 03-06-2013 at 06:17 PM.
Allocate the tax revenue from newly legalized drugs, and existing legal drugs to healthcare. I don't know why I have to explain this to you, you're smart enough.
You will be the only one laughing. All costs being exactly the same, the government doesn't work for shareholders, and the government doesn't have to advertise. I'm sure you can do simple subtraction from here.Oh and I am still laughing at the fact that you think the govt would have lower overhead than a private sector company. The govt already has a model for what would happen with a single payer. It is called medicare/medicaid. In 2011, Kaiser Permanente collected 47.9B in total revenue. Medicare paid about that much just in fraud.
1. http://en.m.wikipedia.org/wiki/Health_care_fraudWhy would I NOT think that medicare's fraud totals wont go up by 10x when 10x the people are added to the scheme? It would probably go up by more than 10x because it would be even easier to commit the fraud because the govt wont be able to hire enough investigators to keep up.
The total cost of healthcare fraud in the US. This includes everyone on any healthcare system right now. You may see a slight bump, but not much.
2. Why wouldn't you be able to hire investigators? You have freed up plenty of workers from current private healthcare administration who already know the system.
Thats just more taxes. A knee repalcement will still cost the same as it did with illegal weed.
They have a far larger and more cumbersome bureaucracy though.
Your link has issues. I would have to find the info again, but I found an article a few years ago while I was in econ class arguing against a single payer that covered this. It estimated medicare fraud 3-5x higher per capita than private sector insurers.
For the same reason they dont do it now. I have no clue what that reason is, but there is very little accountability with medicare spending.
HHS could hire 50k new investigators whose only job is to find and prosecute medicare fraud, pay them 150k a year. If they stopped just 30% of fraud, medicare would be saving money.
Maybe, maybe not. You won't get legal pot though without it being taxed. That is out of the question. If you don't want to pay taxes on weed, don't think about buying weed. Its that simple. Lol.
You can buy it right now and risk jail time, or you can pay the same or most likely less when it's legalized and have the tax revenue go to healthcare and not get a year in prison. I don't know about you, but the choice is pretty clear here. Lol
...a bureaucracy that is already in place and already paid for.They have a far larger and more cumbersome bureaucracy though.
Lets assume this is true, and that there is 3-5x more fraud on Medicare than private. What would you think is the cause? Some of these report say that the average american thinks its ok to defraud a health insurance in order to offset a premium/deductible. If you end up lowering costs for the end user, do you think that will increase or decrease the number of fraudulent claims? Both pages say that health care providers are the most common offenders, so still assuming that there's 3x more fraud claims on Medicare, its most likely the hospital doing it. Ramp up fines and eventually shut down offending hospitals.Your link has issues. I would have to find the info again, but I found an article a few years ago while I was in econ class arguing against a single payer that covered this. It estimated medicare fraud 3-5x higher per capita than private sector insurers.
What you are being billed right now on your private insurance policy offsets fraud and pays for investigation and recovery. I am still shifting dollar for dollar what you pay and what your employer pay from a private insurer to UHS. All of the money that's currently paid into insurance fraud recovery is also shifted
There are already investigators in place in the private sector that you are paying for right now with your private insurance premium. If you're shifting all your expenses dollar for dollar, all these investigators are still doing their jobs at the same rate they were getting paid before.HHS could hire 50k new investigators whose only job is to find and prosecute medicare fraud, pay them 150k a year. If they stopped just 30% of fraud, medicare would be saving money.
California already has issues with this approach. Research San Bernadino County and its issues with healthcare and hospitals. The approach that you are presenting so far will not lower costs, it would simply take and established business from private corporations and place it in the bureaucracy of the government. The current single payer model needs to account for all of the impacts that it would have, and it doesn't have that yet.
Again, I'm not saying that a single payer system cannot be done, just that I have not seen anyone present a complete model that addresses all of the issues, and other developed countries have not presented a system that would work in the US yet.
"Racing is life. Anything before or after is just waiting." - Steve McQueen
Even the Obamacare bill included a massive amount of pork barrel spending. Government is not as efficient as the private sector; however, it usually takes government to tackle massive projects such as national infrastructure, and that places a national healthcare plan as a discussion topic at minimum.
We, the people, are the shareholders. I agree that the government is not working for its shareholders - but it should be.
The government constantly advertises. Turn on the TV, and hear Obama's commercials promoting his agendas.
"Racing is life. Anything before or after is just waiting." - Steve McQueen
Campaign advertisements, not government advertisements.
When was the last time you saw a commercial for WIC, Medicare, or Social security? For a public school, or for a post office? What about a commercial for I-75?
While I don't agree completely with these statements, I think this is an excellent presentation for the angle that you view the issue from.
I don't think that the government can/would lower healthcare costs even if they legalized currently illegal drugs; however, I also don't think that the private sector will lower them either. Cost will continue to rise as they always have. You do not see the government lowering your overall tax burden, only increasing it.
"Racing is life. Anything before or after is just waiting." - Steve McQueen
Actually, there was one for the Post Office this morning; however, they have their own budget and run more like a private business, so I don't think the same terms apply with that part of the government.
Since you bring up Medicare, let's look at its real cost, as that's what we are really looking at - Medicare for all.
What about the claim that Medicare’s administrative costs are only 2 percent, compared to 10 percent to 15 percent for private insurers? The problem with this comparison is that it includes the cost of marketing and selling insurance as well as the costs of collecting premiums on the private side, but ignores the cost of collecting taxes on the public side. It also ignores the substantial administrative cost that Medicare shifts to the providers of care.
Studies by Milliman and others show that when all costs are included, Medicare costs more, not less, to administer. Further, raw numbers show that, using Medicare’s own accounting, its administrative expenses per enrollee are higher than private insurance. They are lower only when expressed as a percentage – but that may be because the average medical expense for a senior is so much higher than the expense for non-seniors. Also, an unpublished ongoing study by Milliman finds that seniors on Medicare use twice the health resource as seniors who are still on private insurance, everything equal.
Ironically, many observers think Medicare spends too little on administration, which is one reason for an estimated Medicare fraud loss of one out of every ten dollars of Medicare benefits paid. Private insurers devote more resources to fraud prevention and find it profitable to do so.
"Racing is life. Anything before or after is just waiting." - Steve McQueen
The weed thing is a small side note. And I cant find anything on San Bernardino. What I understand from what I have seen is that they're trying to apply it locally, using the same market model that causes the mess that we're in already. There are still people coming in, not paying, and not enough participants to find the ones that aren't.
If costs are going to continue to rise, then they will rise with or without socialized medicine, if that's the case we still have a responsibility to do something about ruining people's lives, medically and financially, over hospital bills that are unnecessarily, and prohibitively expensive. Especially since its us thats carrying the burden of that.
It's an increase on some people's tax burdens, but a decrease in out of pocket costs. Worst case scenario, my proposal is a wash for everyone involved. Same money goes in as it comes out.
If instead of paying $200 to BCBS, would you rather pay that same $200 to Uncle Sam if it meant that everyone around you had a better chance of not getting your family sick?
The IRS is already in place and you already pay for it in your taxes. This tax you already pay for doesn't come down. It may rise slightly, but if you're still shifting costs dollar for dollar, this increase is covered.
I can accept that seniors on Medicare are higher than non seniors with Medicare. You're already paying for them right now. The tax you already pay for medicare doesnt decrease. The additional seniors you're adding are the higher income ones who are already paying high premiums on their private insurance. If you're making the system progressive taxed like income is, they might get an additional tax burden.Further, raw numbers show that, using Medicare’s own accounting, its administrative expenses per enrollee are higher than private insurance. They are lower only when expressed as a percentage – but that may be because the average medical expense for a senior is so much higher than the expense for non-seniors. Also, an unpublished ongoing study by Milliman finds that seniors on Medicare use twice the health resource as seniors who are still on private insurance, everything equal.
You already pay for private investigators and all the costs to recover insurance fraud in your premium already. If you're shifting, dollar for dollar, you're still gonna pay for it.Ironically, many observers think Medicare spends too little on administration, which is one reason for an estimated Medicare fraud loss of one out of every ten dollars of Medicare benefits paid. Private insurers devote more resources to fraud prevention and find it profitable to do so.
Two things:
Shifting costs, however, is not the same thing as controlling costs. Providers are just as much a part of society as patients. Shifting cost from one group to the other makes the latter group better off and the former worse off. It does not lower the cost of health care for society as a whole, however. In fact, it introduces a cost to society as the supply of providers falls.
Your goal is to provide fair, universal health coverage for all; however, you method of collecting revenue to support this is anything but fair and universal. You are effectively saying that the few are to support the needs of the many, by removing the gains achieved by work effort and giving it to those who do not have the same documented work effort.
"Racing is life. Anything before or after is just waiting." - Steve McQueen
Shifting costs doesn't lower costs on its own. If everyone were on BCBS, then we decided to shift everyone to Humana, nothing would change. It's another private insurer, same overhead, same business model. Instead, we're expanding an already existing government agency and shifting the costs to it. Only this government agency doesn't have the same overhead costs as the private one, and there is only One CEO. Youre getting rid of the operating costs you don't need by shifting to the agency that doesn't use them.
You control costs because now doctors don't have to triple charge to cover people that can't pay. You introduce legislation to fix prices and make them transparent, and now, a 50 cent Tylenol 3 costs 50 cents, an hour of the nurses time to give you the pill costs 30 bucks, hour of room costs 5-10 bucks, etc. etc. Now, your normal hr long hospital stay for your kid costs $50 instead of $1000. There's no need to do any negotiating from there.
If you've got a worse situation like setting a broken bone, take the best case/worst case scenario, average the two together, or, itemize it out: charge for invasive to go in and cut chunks of bone out if you crushed one, then charge to set it. A broken leg goes from $20k to $4k, whatever. The goal here is to eliminate overcharging.
This works the same way as the current tax setup is now. It works the same for roads, schools, libraries. Progressive taxation. Effectively no one would come out of pocket anymore than what they're already paying. Your wealthy are paying the base rate + the difference for Cadillac care (what theyre already paying now) your poor people still use Medicaid but its now rolled into one big agency. The tax for Medicaid still exists and is rolled into UHS. If you're paying the same rate as what you're paying now, and you lower your overhead, the difference makes up for those on the other end.Your goal is to provide fair, universal health coverage for all; however, you method of collecting revenue to support this is anything but fair and universal. You are effectively saying that the few are to support the needs of the many, by removing the gains achieved by work effort and giving it to those who do not have the same documented work effort.
If you're paying $200 a month to BCBS right now, and that $200 is paying for healthcare costs for you and your wife, investigating fraud, advertising, profits, you'll still be paying $200 to UHS, except now that you've cut out advertising, profits, etc, stuff that a government system doesn't use to actually give you healthcare, now it only costs $100, your extra $100 fills the gap, goes towards low income care, comes off your premium, whatever.
The work effort argument is entirely subjective and purely idealogical. I personally know people who are paid substantially more for doing less effort than the people who put in MORE effort to get paid less. Our machinist makes $50k a year and puts in 80hr work weeks regularly, handling very heavy objects all day long. Our president married into the company, puts in 7hr days max, makes very few executive decisions, none of which couldn't be made by anyone else here. The most physical effort he does is carry the product we make in a truck from our building to the building that uses it, and even then, someone here does it half the time The president gets a paid truck spec'd out 2012 F150, gas card, expensed business trips(to which no money has been made for us, and sometimes essentially lost), and $250k/year.
So, your personal belief is that those that make a little more should received a reduction in the benefits that they receive (the loss of their "Cadillac" health plans), and an increase in cost for this reduction. So much for fairness.....
Person #1:
A guy who chooses to spend his life selling dope, smoking weed all day, never choosing to look for a steady job to hold, who gets cancer after 40 years of not being a contributor to society
Person #2:
A guy who works 90 hrs a week managing his own business, growing it from the ground up, employing a workforce of 75 people, paying his taxes faithfully, living healthy.
You believe that Person #2 should support the healthcare costs of Person #1?
"Racing is life. Anything before or after is just waiting." - Steve McQueen
Show me the math that makes this work.
I have yet to see anything come close to working out this way. Its nice to SAY that , but we both know its more like $20,000 vs $200
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Problem with that is you now eliminate the talent from the pool. That "advertising and profits" is what makes a doctor better than the next.
You assume all doctors will be paid the same, newsflash, they dont want to be.
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That is the whole point of single payer. Take down the people who can afford the BEST healthcare, and make it mediocre, and give people with NO healthcare access to mediocre care.
its about leveling the playing field. Its about "fairness".
Its about taking a great doctor and only allowing him to make averages wages, and letting shitty doctors make average wages.
Its not feasible. They completely ignore the private sector side of business.
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You are both engaging in anecdotal arguments that represent the opposite extremes of the same issue. There will always be people who receive more or less benefits than they "deserve", whatever your definition of deserve is. Our policies should be more utilitarian (the greatest good for the largest number of people) with the caveat that no individual bears too extreme a disproportionate level of the burden. A loser getting healthcare is not a good reason to prevent many good people from getting healthcare and a loser getting lots of money is not a good reason to raise taxes on every wealthy person.
Personally, I would choose the doctor who wants to be a doctor even if it won't make him wealthy over a doctor whose primary concern is profit and advertising.
Most doctors want to be doctors because its helping people, but , most want to be compensated because their costs are $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
Advertising is bad now? Profit is bad now? Are you fucking kidding me?
the BEST doctors ADVERTISE and count on making a PROFIT. do you know what it takes to be a WORLD CLASS DOCTOR? SURGEON? ARE YOU AN EXPERT ON IT?
save me the people of the world unite bit, its old
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What do you do for a living?
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Actually, I can introduce you to a lot of people that fit both of those 2 types that I described.
Sounds like you think that utopia can exist if we simply steal from the rich and give to the poor - even if the poor stay poor because they do not want to put out the effort to better their own lives.
"Racing is life. Anything before or after is just waiting." - Steve McQueen
Couple posts ago I said that everyone gets base care. That means if you were getting and paying for Cadillac care before, your paying less now for base then paying the difference for anything more. I've went over this
Nowhere have I said we're taking any money from the doctors. Private insurers advertise for their own profits, not the doctors.
I offered the anecdote after saying the same thing. This worker to earner argument is purely subjective and has nothing to do with the course of discussion.
This happens right now on the system we're already on. How do you suppose we remedy that?
If both people take a nasty spill and bleed out, which one do you let die?
Sorry. You can't ignore the people of the world unite bit, that's the whole crux of the discussion. Lol. Getting people healthcare who can't otherwise get it.
Something something something more perfect union something something something promote general welfare something.
Your solution doesn't solve anything then. It doesn't really improve anything, it just takes localized healthcare and puts it under a national regulation - and that is the established receipe for worse results at higher cost. In order for a single payer system to ever have a chance to be introduced, there needs to be a clear improvement over the existing system.
Again, I'm not against it - if it can deliver a better system. The current plans just don't offer that yet.
As for who to let die - both would die under the current system or your utopian one. Everyone dies eventually. However, both would receive the same emergency care. We aren't talking about emergency care though - we are talking about healthcare in regards to standarizing the normalized care that individuals receive. The difference is how much should one person pay towards another's care. Again, why should Person #2 be responsible for the needs of Person #1?
"Racing is life. Anything before or after is just waiting." - Steve McQueen
So fucking tired of bleeding hearts.
Actually, they can get it. If you watched the news, you would have seen that plenty of people were down at Greenbriar Mall getting free dental care just last week. There are lots of "free clinics" available to those that need it, and hospitals do not turn away people in need currently, regardless of their ability to pay.
Line forms for free dental clinic at Greenbriar Mall Friday | Video | 11alive.com
Atlanta dentist offers free dental care at Friday event - CBS Atlanta 46
"Racing is life. Anything before or after is just waiting." - Steve McQueen
I don't see you putting up much of a fight against public education? Is this what you're implying? I guess you'll be sticking your kids in private school? Lol
Ive offered that improvement. I'm still not sure where you're lost? It seems that you have an idealogical aversion to it, but its based on the same as the tax system we have in place that everyone's already agreed to. We're just taking the money we're already paying insurance companies for healthcare and giving it to the government. I don't think I could make it any simpler than that. Lol.
Person 2 is already responsible for person 1. You are paying for it on the front end right now. There will always be people who abuse the system. It's a fact of life we have to cope with. My system makes it so that YOU don't have to cope with it as much.However, both would receive the same emergency care. We aren't talking about emergency care though - we are talking about healthcare in regards to standarizing the normalized care that individuals receive. The difference is how much should one person pay towards another's care. Again, why should Person #2 be responsible for the needs of Person #1?
With the track record the govt has, how could anyone be against that? I mean, look how well they have managed the money they confiscated to pay for retirement.
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