Example 27 of why we need universal healthcare…
- Thread starter Tom Paris
- Start date
so in your mind the answer is to tax EVERYONE and have the government tell you what treatments you can and can't have? Sorry, I just don't think that's the answer.
One other thing you should be aware of, treatments for major illness in countries with "free healthcare" could take years. Just one example, there are many Canadians with free healthcare who come to the US for treatments. I play golf with some of them..have a cold - free healthcare is great: need heart surgery or have cancer, - you could wait for years.
Even Medicare doesn't cover everything....
Wealthiest country in the world that's $40 trillion in debt??? In actual terms, that makes us the most indebted nation in the world...China is second with $18 trillion debt
well, in my world, if you're concerned about what your prospective company's health care covers, you ask...
well, what's being proposed is that the federal government run our healthcare. And if I read the posts on here, there aren't a lot of posts praising the actions of the federal government. But, I understand, the government will do a much better job in dealing with our healthcare...
Tom Paris also wants free housing, food, cable tv and an Obama phone.
We tax everyone to pay for the $1.3 trillion military every year. Wringing our hands over healthcare but not the military is dishonest.
Every other developed nation does this. Every other developed nation also has a longer lifespan than us.
I used to think as you do and brother…I am a die hard free market guy normally. We have had pretty good agreement on some free market topics in other threads.
But let me tell you, I have heard all the anecdotes you have. Then I started traveling the world for business. I ran a company where I had offices in 60 countries and thousands of employees worldwide. I started digging into the actual data, not the anecdotes. I will tell you now, the healthcare outcomes in every other western country are the same or better than in the US. The total cost per employee (counting company share, employee share and employee tax burden) is BY FAR higher in the US than any other country.
If your anecdotes on cancer and heart failure were real then the healthcare outcomes would be demonstrably worse in those countries and they just are not. Every western nation has a higher life expectancy than the USA. All of them.
Fun fact, in a statistically significant survey Canadians even have a higher trust in the availability of healthcare than in the US despite your anecdotes. Higher, not lower (link below if you care to learn something about this).
The data is clear and despite my free market bias my personal belief has changed. This the rare arena where the government should play a role. We should provide basic catastrophic insurance under a medicare for all policy where the big stuff and basic preventative care is covered. But I quite like the German model where you can optionally buy into a plan that will give you access to faster care for non life threatening stuff (e.g. knee replacement) access to better/more bespoke facilities, private hospital rooms, and the like.
Survey mentioned above
You can’t compare healthcare outcomes without considering other factors beyond the healthcare system. Yes, that is part of it. But lifestyle factors in the US have a MASSIVE impact on our healthcare costs and outcomes … and those have nearly nothing to with healthcare delivery.
A simple stat is to compare obesity rates. EU is 17-20%. The US is over 40%! Obesity is a massive contributor to many health complications.
Less easy to quantify is Europes better regulation on food supply ingredients, but it is almost certainly a factor in American health outcome disparity.
The US has the best doctors and medical technology in the world. I don’t think the mechanism for which we fund it is the issue. The issue is our diet, lifestyle and far too many disgustingly obese people driving excess healthcare utilization and poor health outcomes.
So you're saying if we had more health regulations on food, we would have better health. Glad you agree that letting corporations shove the unhealthiest foods possible down our throats isn't working so hot.
Oh yea, I’m in agreement there. I’m not a huge government regulation fan, but we need a lot more of it with our food supply. I was hoping MAHA would work toward this, but that’s been a failure.
No disagreement on obesity, but part of that is tied into preventative care which is often expensive/unavailable for the underinsured in the USA.
However, putting it all on obesity is absolutely ignoring the other glaring aspects of how much more expensive a drug, procedure, etc is here vs any other place on the planet. The data is completely clear and obvious.
But why would I want to pay more in taxes when my employer pays my healthcare?
Like I said, find a better employer if your healthcare sucks.
This is a red herring on the order of the plastic recycling campaign of the 70's... which was run by the plastic companies so they could continue to operate at full speed. The idea that Europe is healthy because they don't allow red #40 in their food is BS. They DO allow it, it's called E129 and it will be phased out in the US in just a few years but that was never the problem and won't make even the tiniest difference in health outcomes. While we focus on "additives", the food companies just keep on doing what they do.
Europe's better health outcomes are dependent on their food delivery systems. Europeans still shop at the local butcher... the local baker. They buy fruits and vegetables in the markets located in their walkable and bikeable cities. Meanwhile, we drive to the grocery store where 70+% of the food is highly processed, loaded with sugar, and bereft of nutritional value. We grab fast food and snacks at convenience stores. We live sedentary lives and pound down the empty calories. And the food companies are happy to supply them.
BTW, 90+% of all plastic put in your recycling bin, never gets recycled. It goes to the dump or gets incinerated. And the plastic manufacturers are doing just fine.
Oh hey, your back. Maybe you can reply to my response I sent you yesterday.
I’ll quote it again for you.
You don’t need a doctor to tell you to eat healthier and exercise. I don’t buy the preventative care as an excuse for dramatically higher obesity rates.
Price is certainly an issue, but it’s a lot more complex than just pivoting who pays for it (which is all you are doing with UHC). We should approach cost reductions in a variety of ways and those can be accomplished in the current financing system.
Not to mention, the higher price is directly related to having to most innovation, the best medical devices, the best pharma research and the most talented physicians in the world. Bare bones funding of those things means bare bones results. I’m okay paying more for the best.
I wasn’t saying it was just access to preventative care. Education, easy access
to cheap high calorie foods, laziness, healthy food deserts and more all play a part.
My proposal where people can buy a supplemental plan to get access to the best is very viable. I’, not trying to give everyone the best of everything. I’m controlling for a cancer diagnosis leading to lifelong economic consequences for a family. Provide government insurance for catastrophic issues and preventative care. Allow supplemental private insurance for the non life threatening stuff.
Or we could ignore ALL the data. Put our head in the sand and keep doing it your way. It isn’t working and hasn’t been working for decades. But don’t let that stop you.
Im not suggesting that we keep doing it the way we are doing it. I am saying that I don’t want to shift funding from individual and employer premiums to extra taxes and more government involvement in allocating those dollars.
We also need to start rating people based on controllable health factors. It’s simply not fair for a healthy person who has a clean diet and normal BMI to pay the same premium as a morbidly obese person who crushes fast food on the reg.
Oh, I'd be fine with a basic catastrophic plan - although would not need to be covered by the government, private insurance could do the same thing but I don't think the government would allow it. There are specifically designated things health insurance must cover (if I remember correctly)And even under Medicare there is a cost to the individual for coverage..means tested as you might know.
There would be multiple options that health insurance could cover...and I'm all for exploring each and every one.
But. Government run and administered healthcare would be a disaster, IMO. Look at the fraud we have now...I could see exactly what you described for those who wanted out of the individual mandate, my grandson would love something like a catastrophic plan with options for supplements for other needs...But that's a far cry from Medicare for all.
I'm envious, I only had 26 overseas offices but had sales in 76...at the time 2007 we did $4 billion in sales
I don't think it's that simple....Government does not have the employees to administer healthcare..there's a cost....Medicare reimbursements to providers - doctors and hospitals - will not keep hospitals open not doctors paid. Our system now has private insurance reimbursements make up the difference because of the lower government rates...There are already some hospitals closing their doors because they deal with too many Medicaid Medicare patients.
Medicare for all has such a nice simple ring to it. I just don't think it's the panacea that others do....look at the ACA. It was going to lower prices, save us money, make healthcare better..and it's really done none of those things. We still see "go fund me" for healthcare costs...
universal care may not be the solution but that massive bloated garbage that sits presently between caregivers and recipients must go. somehow anyhow. as a first step, after insurance behemoths magically disappear overnight, i would be fine with every provider having to mandatorily expose a clearly defined pricing menu and customers paying with their own hard earned cash while great debates rage on what if anything should fill the vacuum. ideally in 2 years time services and pricing will reach a equilibrium that everyone will be happy with and no intervention will be necessary.
I agree 100% that healthcare in the USA is too expensive but I disagree with your contention that countries with universal healthcare have similar better outcomes than the U.S. This is largely based on life expectancy but the fact is U.S. citizens are fat arses.
Obesity rate by country:
USA 42%
Germany 24%
France 13%
Spain 19%
Italy 18%
UK 29%
Canada 27%
China 9%
Japan 5%
People living in those countries walk or ride bikes. We drive a car to work then go home and lay on the couch. The U.S. results aren't due to poor healthcare.
Rankings of top hospitals in the world:
- Mayo Clinic
- Cleveland Clinic
- Toronto General
- John's Hopkins
- Karolinksa
- Mass General
For-profit insurance companies make between 1-5% profit margin. Many, including most BCBS plans, are non-profit. United healthcare made 2.7% profit last year. Not exactly a ton of margin to eliminate.
The cost of employees would need to be covered for government healthcare to consider it breaking even. Private companies be profitable for the shareholders beyond paying for employees salaries.
Who says the taxes would be higher than what you pay out of pocket now? Looks to me like countries with Universal healthcare actually spend less.
"Americans pay significantly more for healthcare than citizens in Canada and Europe, both in total per-capita spending and in out-of-pocket costs. While Canadians and Europeans fund their universal systems primarily through broader taxes, Americans pay a compounding mix of taxes, private insurance premiums, deductibles, and co-pays.
Annual healthcare spending per person in the U.S. is roughly $14,775, whereas comparable costs are $7,301 in Canada, $9,365 in Germany, and $9,963 in Switzerland.
How does health spending in the U.S. compare to other countries? - Peterson-KFF Health System Tracker
This chart collection examines how U.S. health spending compares to health spending in other similarly large, wealthy OECD countries using the OECD Health Statistics database.
www.healthsystemtracker.org
I have similar experiences but admittedly not in 60 countries. Do you realize that foreign subsidiaries of most large U.S. corporations provide private insurance as a perk to their executives? Why do you think that is?
I agree that the cost per person in the USA is ridiculously high. I strongly disagree that the solution is as simple as having the government run it. I think we need to identify the cost drivers and go from there. Other countries pay their providers half what we pay. That's not an easy fix. Other countries have stricter limits on medical liability and have longer wait times for certain specialists. Getting the cost from $14k per person to $8k per person isn't as simple as having the government run things.
Iowa BCBS is a for profit mutual insurance company. United Healthcare's 2.7% net profit was 12.1 billion. That's about $20 profit per insured individual each month.
The USA spends significantly more than other countries but insurance company profits are hardly the problem. The majority of BC/BS operations are not for profit. Most hospitals are not for profit. The largest private insurer is United Healthcare. Their revenues (premiums) were $450 billion and their net income was $12 billion. That's just a little over 2%. How would eliminating that 2% lower insurance costs by 40%?
Keep in mind that Obamacare created co-ops in each state. They were non profit AND they received federal subsidies. Every single one of them failed because they couldn't compete.
The problem is most working Americans think of their health insurance as being free from their employer. They have no idea how much their employer is spending monthly on their insurance that could be put back into salary if not for health insurance costs.Who says the taxes would be higher than what you pay out of pocket now? Looks to me like countries with Universal healthcare actually spend less.
"Americans pay significantly more for healthcare than citizens in Canada and Europe, both in total per-capita spending and in out-of-pocket costs. While Canadians and Europeans fund their universal systems primarily through broader taxes, Americans pay a compounding mix of taxes, private insurance premiums, deductibles, and co-pays.
Annual healthcare spending per person in the U.S. is roughly $14,775, whereas comparable costs are $7,301 in Canada, $9,365 in Germany, and $9,963 in Switzerland.
How does health spending in the U.S. compare to other countries? - Peterson-KFF Health System Tracker
This chart collection examines how U.S. health spending compares to health spending in other similarly large, wealthy OECD countries using the OECD Health Statistics database.
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That's 100% true but those countries have different inputs. You can't cut costs from $14k to $8k by keeping everything the same except allowing the government to run it.
Yes but it still looks like we pay more out of pocket per capita
The Hidden Trap: U.S. Taxes and Premiums
While European and Canadian taxes for healthcare are higher than American out-of-pocket cash costs, the U.S. system is overall far more expensive for the individual due to three factors: [1, 2, 3, 4]
- Higher Public Tax Burden: Even without universal care, the U.S. government spends more tax dollars per capita on healthcare programs (like Medicare, Medicaid, and the VA) than almost any European nation. Americans pay roughly $8,249 per capita in taxes just to fund public health programs. [1, 2]
- The Premium Elephant in the Room: The "out-of-pocket" figure ($1,425) does not include insurance premiums. The average family health insurance premium in the U.S. is nearly $27,000 annually. This cost is split between employers and workers, heavily reducing take-home pay. [1, 2, 3]
- Compounding Expenses: A citizen in Europe or Canada pays their tax and is mostly done with healthcare expenses. An American pays a high healthcare tax, pays a massive premium out of their paycheck, and then must pay out-of-pocket costs when they get sick. [1, 2]
| Country [1, 2, 3, 4] | Public Tax Funding (Per Capita) | Average Out-of-Pocket Spending (Per Capita) | Total Healthcare System Cost (Per Capita) |
|---|---|---|---|
| United States | $8,249 | $1,425 | $14,775 |
| Germany | $6,930 | $883 | $9,365 |
| Canada | $4,506 | $941 | $7,301 |
| United Kingdom | $4,479 | $764 | $6,747 |
True Costs
I'm 100% in agreement with you. It's just that every time we have one of these discussions there are always posters saying their health insurance doesn't cost them anything because their employer pays for it.
Got ya, it's because they aren't considering all the costs ;-)
United Healthcare charges roughly $15k per person to provide health benefits. You're saying that things would be much better if they eliminated profits and reduced premiums to $14.8k per person?
Do you really think that's the problem?