DSA - How Will this Work?

[jimneffer]

We can move towards the single payer system that you seem to be suggesting,... Just understand that when that system is imposed upon the previously discussed scenario no helicopter transport would be offered, and the woman's son would have simply died at the first hospital, which would likely be even more severely lacking in it's ability to provide care.

do you honestly think helicopter transport for medical emergencies is unique to the US ?

i understand that half (more?) of your comments are completely disingenuous...but even this is a stretch for you.

 

[hawkeyetraveler]

We can move towards the single payer system that you seem to be suggesting,... Just understand that when that system is imposed upon the previously discussed scenario no helicopter transport would be offered, and the woman's son would have simply died at the first hospital, which would likely be even more severely lacking in it's ability to provide care.

Umm…except people get those services in countries with public insurance options.

This is not binary. It’s not you get a life saved I. The US or you die in Canada. The data does not support that at all.

 

[Rifler]

do you honestly think helicopter transport for medical emergencies is unique to the US ?

Of course not, and I didn't say that,... What I did imply was that a luxury service like helicopter transport will become a rare event with the traditional single payer approach.

 

[jimneffer]

Of course not, and I didn't say that,... What I did imply was that a luxury service like helicopter transport will become a rare event with the traditional single payer approach.

and yet...many of those single payer systems are able to consistently produce better outcomes than our system...for a much lower cost per person

 

[Rifler]

Umm…except people get those services in countries with public insurance options. This is not binary. It’s not you get a life saved I. The US or you die in Canada. The data does not support that at all.

The data supports the fact that with a traditional single payer system there will be significant rationing of services,.. Things like helicopter transport will become very rare.

 

[Rifler]

and yet...many of those single payer systems are able to consistently produce better outcomes than our system...for a much lower cost per person

You realize that those outcomes and costs reflect the "average" right?,... Most working Americans with reasonable health care coverage are currently seeing medical outcomes far superior to the average,... But under a traditional single payer system everyone will become "average", which will be good for some of the population, but very bad for the majority who will still bear responsibility for paying the bill.

 

[hawkeyetraveler]

The data supports the fact that with a traditional single payer system there will be significant rationing of services,.. Things like helicopter transport will become very rare.

Rationing or wait times happen for elective procedures not lifesaving procedures in these countries. The data is quite clear on that. As life flights are life saving in nature I don’t know why you would jump to that conclusion. Have any data to back it up?

I prefer a German style system where you can buy private supplemental insurance to ”jump the line” or get more choice of provider if you want. My personal belief is we need to eliminate catastrophic financial consequences of healthcare with a public option. I’m not in favor of no choice though so let people buy into a better plan if they want.

 

[Rifler]

I prefer a German style system where you can buy private supplemental insurance to ”jump the line” or get more choice of provider if you want.

As do I.

 

[jimneffer]

You realize that those outcomes and costs reflect the "average" right?,... Most working Americans with reasonable health care coverage are currently seeing medical outcomes far superior to the average,... But under a traditional single payer system everyone will become "average", which will be good for some of the population, but very bad for the majority who will still bear responsibility for paying the bill.

i realize this is the general response for people who seem hell bent on preserving a system that delivers these outcomes (link to study here) for 1.5X cost per capita

is there variability in outcomes in our system? absolutely. is there variablity in outcomes in those other systems? i would think so, but you seem to know there's not. i guess the question is - what does that difference in variability have on individual outcomes.

and none of this addresses the proverbial elephant in the room - cost of healthcare. if you really think the future of our nation hinges on managing costs - whther govt spending or what a family spends on healthcare (and i'd argue those are eventually the same thing given the cost of medicare and medicaid) - you can't just ignore that we PAY MORE THAN 1.5X THAN ANY OTHER NATION FOR HEALTHCARE.

 

[Rifler]

i realize this is the general response for people who seem hell bent on preserving a system that delivers these outcomes (link to study here) for 1.5X cost per capita

is there variability in outcomes in our system? absolutely. is there variablity in outcomes in those other systems? i would think so, but you seem to know there's not. i guess the question is - what does that difference in variability have on individual outcomes.

and none of this addresses the proverbial elephant in the room - cost of healthcare. if you really think the future of our nation hinges on managing costs - whther govt spending or what a family spends on healthcare (and i'd argue those are eventually the same thing given the cost of medicare and medicaid) - you can't just ignore that we PAY MORE THAN 1.5X THAN ANY OTHER NATION FOR HEALTHCARE.

And that probably won't change for the better,... If we are lucky, with a traditional single payer system, we will continue to spend at your indicated 1.5X while providing an average level of care to every citizen,... If we aren't lucky, that average level of care will be decried as unacceptable and the program will be expanded and cost will inflate to 2.0X or more,... Giving every US citizen the level of healthcare that most of us have become accustomed to is going to cost more money than we are currently spending....

 

[jimneffer]

And that probably won't change for the better,... If we are lucky, with a traditional single payer system, we will continue to spend at your indicated 1.5X while providing an average level of care to every citizen,... If we aren't lucky, that average level of care will be decried as unacceptable and the program will be expanded and cost will inflate to 2.0X or more,... Giving every US citizen the level of healthcare that most of us have become accustomed to is going to cost more money than we are currently spending....

how do you think virtually every other developed country manages to do it?

 

[HoggI74]

how do you think virtually every other developed country manages to do it?

With tax rates that approach 50%...

 

[FLaw47]

With tax rates that approach 50%...

We must remember, everyone, that converting your health insurance premiums to tax revenue is really bad for reasons.

 

[baltimorened]

People are making an argument against the system itself, but your argument does not address the system at all. Your argument is she got what the system delivered her by contract. That is NOT an argument FOR the system, if anything it is yet more proof that the system is broken since a parent has to contemplate bankruptcy in exchange for a life.

You suggest we accept a devil’s bargain simply because that is the way the system is today. But in every other western nation this scenario does not happen. And they have better health outcomes than the US. Therefore the system IS broken and your argument is actually reinforcing how broken it is.

couldn't we solve this if there was a catastrophic care option, or maybe even a standalone "add on" polic

and yet...many of those single payer systems are able to consistently produce better outcomes than our system...for a much lower cost per person

you say that and you might be right about routine care, but other than routine can take a year or more to get an appointment. I realize that's a general statement, it depends on where you live. But, it's a lot better here

I think a lot of you might be looking at this through a grass is greener concept. To be sure, our system is not perfect and neither are the potential solutions many of you are proposing.

For sure a health incident should not bankrupt a family. We should have some form of catastrophic insurance for that.

Insurance is just that. We all want to pay the lowest possible premium and get the maximum coverage. The concept of health insurance isn't significantly different that other insurance, for example, home insurance. You have plenty of options to buy, but if you chose not to buy tornado or flood insurance and one of those happens. you're financially screwed just the same as if you didn't have health insurance.

.

 

[baltimorened]

i realize this is the general response for people who seem hell bent on preserving a system that delivers these outcomes (link to study here) for 1.5X cost per capita

is there variability in outcomes in our system? absolutely. is there variablity in outcomes in those other systems? i would think so, but you seem to know there's not. i guess the question is - what does that difference in variability have on individual outcomes.

and none of this addresses the proverbial elephant in the room - cost of healthcare. if you really think the future of our nation hinges on managing costs - whther govt spending or what a family spends on healthcare (and i'd argue those are eventually the same thing given the cost of medicare and medicaid) - you can't just ignore that we PAY MORE THAN 1.5X THAN ANY OTHER NATION FOR HEALTHCARE.

yea but dig deeper in your 1.5x statement...why do we pay more...drug cost, salaries of physicians, innovative equipment, research and development costs?? Maybe we could fix the high cost areas without blowing up the entire system

 

[scotchtiger]

Whenever we have change management training at work, they talk about how there are different types of people as it relates to the change. I'm paraphrasing here but it's like the enthusiastic supporters, the tepid supporters, the tepid opposers, and the militant opposers. The consistent theme is "the militant opposers aren't interested in doing anything and are going to tank the whole initiative with their bitterness. Don't try to change their mind; exclude them from the conversation".

I think we need many changes in US healthcare. I would just approach it very differently and don’t think government funded healthcare is the answer.

And if we aren’t in pursuit of something with higher quality and lower cost, then what’s the point exactly?

 

[scotchtiger]

how do you think virtually every other developed country manages to do it?

Healthier lifestyle and diet
Substantially lower rates of obesity
Substantially higher taxes
Largely dependent on the US for medical innovation


“By most broad measures, the United States is the world’s leading source of healthcare innovation. While other countries excel in specific areas, the U.S. produces a disproportionate share of breakthroughs across pharmaceuticals, biotechnology, medical devices, AI in healthcare, and academic medical research.”

 

[fatpiggy]

Rationing or wait times happen for elective procedures not lifesaving procedures in these countries. The data is quite clear on that. As life flights are life saving in nature I don’t know why you would jump to that conclusion. Have any data to back it up?

I prefer a German style system where you can buy private supplemental insurance to ”jump the line” or get more choice of provider if you want. My personal belief is we need to eliminate catastrophic financial consequences of healthcare with a public option. I’m not in favor of no choice though so let people buy into a better plan if they want.

It’s interesting that you support “pay to jump the line”. Seems like the left demonizes the rich, and that’s exactly what they despise, rich people being able to cut the line just because they are rich.


I agree with your overall sentiment though. A basic level of care, with possible supplemental insurance. The problem is, who determines what a base level of care is? Very difficult to make those determinations and it will suffer mission creep due to “compassion”.

 

[fatpiggy]

I see everyone talking about the German model, so did some reading on it.

First question, it cited that Germans pay 17.5% of gross income for healthcare. Seems like a lot.

They also have a commission set to decide what the basic level insurance package covers.

Supplemental insurance - only 10-% of people purchase supplemental insurance


What do we pay for Obamacare?

 

[scotchtiger]

Curious if people actually understand this…

Did you know that a significant majority of government funded healthcare in the US is actually administered by private insurance companies?

55% of Medicare participants actually received coverage through private Medicare Advantage plans.

75%+ of Medicaid participants are covered by Medicaid Managed Care Organizations, which are private insurance companies.

100% of Medicare part D (prescription drug coverage) is administered by private insurance companies.

I’m not sure the people advocating for government healthcare even understand how the current government provided healthcare works. Most involves the government cutting checks to private insurance companies. Those expecting some revolutionary change that nukes the current system they seem to despise will be disappointed.

 

[baltimorened]

It’s interesting that you support “pay to jump the line”. Seems like the left demonizes the rich, and that’s exactly what they despise, rich people being able to cut the line just because they are rich.


I agree with your overall sentiment though. A basic level of care, with possible supplemental insurance. The problem is, who determines what a base level of care is? Very difficult to make those determinations and it will suffer mission creep due to “compassion”.

isn't that what the ACA did...set the level of care.

 

[fatpiggy]

isn't that what the ACA did...set the level of care.

And then it’s not good enough, it needs to cover more. Etc

 

[baltimorened]

And then it’s not good enough, it needs to cover more. Etc

yes, but if that's what's needed in order to make it better for Americans, isn't that the right thing to do?

 

[TC_Nole_OX]

 

[FLaw47]

Nm

 

[dpic73]

GOP’s ‘Big Beautiful Bill’ erases 12 years of solvency for Medicare trust fund: CBO

Congressional scorekeepers expect the Hospital Insurance trust fund to run dry more than a decade earlier than they previously expected, after Republicans’ megabill slashed the revenues it receives from taxes.

www.healthcaredive.com

 

[fatpiggy]

 

[FLaw47]

I think we need many changes in US healthcare. I would just approach it very differently and don’t think government funded healthcare is the answer.

And if we aren’t in pursuit of something with higher quality and lower cost, then what’s the point exactly?

Maybe I'm being uncharitable but I believe you want it cheaper and better for you , which makes me believe you're not actually interested in solving this in any useful way. Sort of like how every policy union says "well obviously police brutality is bad" but somehow have never once said "yeah, this was police brutality, fire the guy."

 

[TC_Nole_OX]

Democratic Socialists are FDR Democrats





Zohran Mamdani:

We’re not running away from the Democratic Party. We’re going back to what the party used to be.

You think about FDR and LaGuardia. You think about the New Deal. That’s what the Democratic Party once was. That’s what it could be again.

And if we want to win, I think that’s what we have to become.

 

[TC_Nole_OX]

 

[baltimorened]

Maybe I'm being uncharitable but I believe you want it cheaper and better for you , which makes me believe you're not actually interested in solving this in any useful way. Sort of like how every policy union says "well obviously police brutality is bad" but somehow have never once said "yeah, this was police brutality, fire the guy."

maybe I'm being equally uncharitable, but I think every person wants it cheaper and better for them. I personally haven't seen anybody, even those pushing for Medicare for all or a single payer system post "I'm willing to pay more and get worse healthcare". The question is how do we get to a better outcome for everybody, recognizing that even if you come up with such a program, the extremely wealthy will still have the money to get better care - not for less money, but better healthcare.

We can debate or even argue about what's better without poking fingers in each other eyes...IMO, there is no perfect solution. I'd bet that even people who have "free" healthcare in other nations have complaints about their care. In fact, I lived in the UK and worked with people who couldn't get the care they thought they were entitled to.

 

[TC_Nole_OX]

Oliver Larkin DSA

 

[FLaw47]

L

maybe I'm being equally uncharitable, but I think every person wants it cheaper and better for them. I personally haven't seen anybody, even those pushing for Medicare for all or a single payer system post "I'm willing to pay more and get worse healthcare". The question is how do we get to a better outcome for everybody, recognizing that even if you come up with such a program, the extremely wealthy will still have the money to get better care - not for less money, but better healthcare.

We can debate or even argue about what's better without poking fingers in each other eyes...IMO, there is no perfect solution. I'd bet that even people who have "free" healthcare in other nations have complaints about their care. In fact, I lived in the UK and worked with people who couldn't get the care they thought they were entitled to.

I have consistently said I'm will to pay more so everyone can have coverage. In case you've missed it, I'm saying it explicitly again.

 

[TC_Nole_OX]

This and capitalism with guardrails

 

[TC_Nole_OX]

 

[baltimorened]

L


I have consistently said I'm will to pay more so everyone can have coverage. In case you've missed it, I'm saying it explicitly again.

well, I'll put you down as the one person, thanks

 

[FLaw47]

well, I'll put you down as the one person, thanks

I believe you're being pretty obstinate on this. I think most of the board who supports leftward health reform expects to have to pay more, personally.

 

[gohawks50]

I believe you're being pretty obstinate on this. I think most of the board who supports leftward health reform expects to have to pay more, personally.

I'm on Medicare so according to Ned I should oppose healthcare for all because I would probably pay more with new taxes. I'm totally for a move toward universal healthcare even though that means I will pay more.

 

[baltimorened]

I believe you're being pretty obstinate on this. I think most of the board who supports leftward health reform expects to have to pay more, personally.

You might be right. But without knowing what a plan is, it's hard to tell how much more or less you might pay. If the mandate becomes a basic single payer (without all the Obamacare mandates like pregnancy coverage) and get your own higher level coverage, i.e., a supplemental, premiums for a lot might go down

I;m not trying to be obstinate. I just don't think Medicare for all is feasible - and I determine that to be Medicare as it is today. Others talk about a single payer, but that means different things to different people.

I just don't think you blow up the system we have until you can define what you're going to replace it with. You don't leave your wife for another woman, unless you've got the other woman lined up..

 

[FLaw47]

You might be right. But without knowing what a plan is, it's hard to tell how much more or less you might pay. If the mandate becomes a basic single payer (without all the Obamacare mandates like pregnancy coverage) and get your own higher level coverage, i.e., a supplemental, premiums for a lot might go down

I;m not trying to be obstinate. I just don't think Medicare for all is feasible - and I determine that to be Medicare as it is today. Others talk about a single payer, but that means different things to different people.

I just don't think you blow up the system we have until you can define what you're going to replace it with. You don't leave your wife for another woman, unless you've got the other woman lined up..

I don't even want Medicare for all but I think it's a little absurd to claim that all of us who want to get more people to covered would refuse to pay more. You've now had two for two telling you they understand the deal with this so I'd ask you remove the "left is liars" talking point and keep focused.