If its mandatory why is it better then single payer

[fenriswolf]

alright all you hillerians. If its so great that we are finally going to have universal healthcare whats wrong with single payer? that we we all pay for it just like in hillaries plan and we pay a percentage of our income same as hillaries. Plus this way 30% of what we pay doesnt go to "administative costs"

oh yeah thats right hillaries friends with insurance companies and they wouldnt like that idea. silly me.

[busymom]

1. The problem that I have with single payer: medicare

Look at it. As much of an evil as the corporate world is, our govt. seeks to save as much money as it can on the backs of anyone insured by govt. healthcare. If our govt did a better job of managing programs like medicare, I'd be more willing to throw my support behind it. As it is, we can create competition in the marketplace, allowing people to choose the best program for them....while still making sure that coverage is universal.

Having lived in the UK, I can say that the govt. plan failed some people miserably.

[fenriswolf]

4. I have used medicare

whats the problem with it?

[dkf]

6. Oh so you think for-profit companies do better than a government program?

And I say there are a whole lot of private companies failing people miserable too.

Look at Natalie Sarkasian. I wouldn't call that a success story at all.

[shraby]

9. I haven't heard of anyone having problems

with medicare either. My husband and I are on it, my parents were on it and my grandparents were on it and zip problems.

[Avalux]

2. Bingo! Any plan Hillary puts forth will be designed to benefit the cos.

I don't trust the woman at all.

[Garbo 2004]

66. It mimics John Edwards' plan. It's not original. It's based on Edwards' proposal. n/t

[nancyharris]

3. If you think the government

will not also consume 30% in administrative costs, I suggest you are dreaming (or not paying attention).

[fenriswolf]

5. look up medicares administrative costs

their is a big differance. and medicare does not use 30%. do your homework and pay attention.

[dkf]

11. Traditional medicare admin costs are 2%.

The latest HCFA data show that administrative costs for beneficiaries in HMOs have skyrocketed to 9.1% while traditional Medicare's administrative costs are 2%.

http://medicare.commission.gov/medicare/robinstest.html

[fenriswolf]

12. thanks for doing his homework for him.

[nancyharris]

17. Medicare covers far fewer people than HMOs,

of course their administrative cost is lower (Dugh!). Medicare also does not provide the array of medical coverage that HMOs provide.

[fenriswolf]

20. they cover far less fewer people

so the amount of administration costs is lower. But pennies on the dollar it is cheaper. percentage wise it is cheaper because medicare does not use our money to advertise, to give CEOs golden parachutes, this is why for profit is bad. jeeze I cant believe you are defending HMOs.

[dkf]

21. I would think that medicare covers more people than the largest HMO

That doesn't sound right.

[nancyharris]

27. No. Medicare covers fewer people than private HMOs

and their cost per person covered is much higher.

[aint_no_life_nowhere]

42. Isn't medicare covering a class of individuals far more likely to be ill?

Many people have HMO coverage even thought they're young and not sick. Medicare covers individuals who are older and far more likely to have medical issues per capita and medical issues of a far more serious nature per capita.

[nancyharris]

47. That is indeed true eom

[RUMMYisFROSTED]

8. Medicare admin costs are 2-5%.

Someone is dreaming.

[nancyharris]

19. 2-5% of What?

[RUMMYisFROSTED]

24. Total expenditure.

If the Medicare budget were $100, the admin costs would be $2-5.

[nancyharris]

26. Economics 101

The average medical cost for Medicare is estimated to be about $6,600 per person per year. The average medical cost for private health insurance is $2,700 per person per year.

Because of the higher cost per beneficiary, Medicare’s method of calculation makes administrative costs, appear to be lower than they really are (because their cost per person insured is higher). If the numbers were adequately “handicapped,” they would be in the 6 to 8 percent range.

[fenriswolf]

29. thats because buisness does not pay for medicare

remember buisnesses pay alot of your health care when its provided through work.

[RUMMYisFROSTED]

33. And the portion paid by employees has risen every year.

While benefits have declined.

[nancyharris]

39. Actually

If one has employer private health insurance and has family coverage and has one member of the family on Medicare, the private insurance is the primary insurer and Medicare is the secondary insurer. Claims made by the person on Medicare are actually paid by the private HMO.

[fenriswolf]

41. thats hillarious

someone with insurance also has medicare. And you don't see how for profit systems is broken? how for profit is just wrong?

[nancyharris]

44. Apparently you are unable to read.

Someone with private FAMILY health insurance that has FAMILY member with Medicare...

[RUMMYisFROSTED]

32. More like Bullshit 101.

The average cost of healthcare was $11,000 in 2005.
http://www.usatoday.com/money/industries/health/2005-09-14-family-health-policy_x.htm

[nancyharris]

37. That price is not per person

You idiot!

[RUMMYisFROSTED]

38. Do the math.

$11,000-$2,700= $8,300.

$6,600= $6,600.

Edit to add before I have to explain it, too: The cost of employer provided healthcare is written into the bottom line. E.g., when you buy a car, the cost of that company's healthcare per worker is represented in the price of that car. So you pay your HC premium and a portion of every employer provided HC plan. Not to mention, you also pay the cost of the uninsured through state, local and property taxes when they hit the ER.

[nancyharris]

40. Do the math

$11,000 / family of 4 = $2,750.00

[RUMMYisFROSTED]

43. See edit.

Edit to add before I have to explain it, too: The cost of employer provided healthcare is written into the bottom line. E.g., when you buy a car, the cost of that company's healthcare per worker is represented in the price of that car. So you pay your HC premium and a portion of every employer provided HC plan. Not to mention, you also pay the cost of the uninsured through state, local and property taxes when they hit the ER.



Plus you have to figure in deductibles and what each plan covers.

Plus medicare recipients tend to be sicker than those with privately held plans, adding to cost.

Plus private cost includes profit, public does not.

[nancyharris]

46. Private insurance includes profit, public does not...

Private insurance includes INVESTMENT, public does not. Who the hell do you think pays for all of the hospital and HMO equipment and buildings?

Under single payer health insurance employers will STILL be paying for health insurance because their taxes will increase. Health Care is not FREE - you idiot!

[Solon]

48. No shit, now shut the fuck up...

A lot of us are a lot better educated about this issue than you ever could be. You'd hate to be the one who comes across as the idiot.

[nancyharris]

50. If you are better educated on the subject

you sure as hell don't show it. Your view of American health care is sophomoric and naive.

[Solon]

54. Damn you are quick to judge, I didn't even say anything about American health care...

fancy that. :eyes:

[nancyharris]

55. That's what you get

when you tell people to "shut the f##k up"

[RUMMYisFROSTED]

56. Pretty pictures!

Per person spending. Which one has private insurance?



From the Whitehouse.



Per capita 2003

[nancyharris]

57. I hate to waste time on you but

out of your "Pretty Pictures" list, the only country that does not have private health insurance is UK. All of the rest rely on a combination of private and public health care. Japan, for instance (and many other of the countries) has compulsory employer health insurance coverage. Most countries use a combination of compulsory employer, compulsory individual and tax supported public funding to support their universal health care systems. In addition, these "Pretty Pictures" do not speak to the quality of health care, only the cost.

Please do some in depth study on this subject and don't fall for simple "Petty Pictures" - it's unbecoming.

[Bluerthanblue]

7. it ISN'T- many people don't make the distinction. Single payer is

what we need-

And it would by nature be "Universal"-

The reverse, unfortunately is NOT true.

peace~

[librechik]

10. as I understand it, low income patients will receive govt subsidies

to buy the insurance. It's just a way to preserve the insurance industry while providing minimum care. Ecerybody seems to think it would be too traumatic to cut the insurance companies loose and go for straight single payer Medicaid for all. To mee it sounds a lot more expensive to keep the insurance co/lobby in the loop. But perhaps, for now, we have to take baby steps.

It makes me so angry--it just adds another layer of profit taking to what our taxes must buy, just like privatizing the military, SS and all that crap. We are being looted by international corporations with the full consent of our "representatives.

[fenriswolf]

13. whats next

hillary gonna endorse which insurance company she likes best?

[shraby]

14. The government has been taking "baby steps"

since the 1960s and they still haven't gone 2 full steps. How long must we wait?

[busymom]

15. The problem with medicare

I'm not sure who to reply to, so I'm posting a general reply...

Is that medicare refuses to pay...and it takes them forever to do so.

Now, I know that you all like to get your paychecks on time and without hassle so that you can pay your bills. The same goes for doctors who have to pay rent, overhead, nurses, medical technicians, lab fees etc. Medicare pays pennies on the dollar....and it isn't enough for hospitals to pay for things like MRI scanners, PET scanners, CT scanners, X-ray machines, lab tests and employees, etc.

As a result, many good physicians are opting out of seeing medicare patients altogether in their practices. Medicare patients use a lot of resources and don't pay for them. It is not sustainable. Their care is then often relegated to mid-level providers who some don't want to see but are forced to.

It is an issue.....and everytime we have financial problems in this country, the first places that seem to be cut are in medicare. Look at Bush's new plan for the budget again. My mom is a NP who works with medicare patients only (because the physicians in her practice won't anymore). She works 12 hour days to earn enough money to pay off her school loans and cover her average mortgage and living costs....nothing fancy....and she kills herself working.

Our govt. overnegotiates prices and it can because there is no alternative for older americans or other americans on the system.

As an insider to the healthcare system professionally....I can vouch for this.

[fenriswolf]

16. medicare payed for everything

Me and my gf at the time became pregnant and (personal story) I ended up becoming an unexpected father. Medical bills came pilling in 15K 500, 2,500 all in all having a kid is expensive and i nearly had a heart attack. We mailed every bill to medicare and guess what. No issue, none. Over 20K in bills for having one child with no complications and mediacare helped us out big time. I will never say anything bad about medicare because the system does work.

Sorry people don't want to see medicare patients. If we didn't have all the insurance companies with different plans and different ways of paying it, if everyone was equal their would be no issue if a doctor was to see them or not.

[Bluerthanblue]

18. medicare? are you sure? or was it Medicaid- that is a horse of

a different color.

peace~

[fenriswolf]

22. interesting, alwasy thought the two were the same

I must profess ignorance as to the differance, perhaps you can school me.

[Bluerthanblue]

36. I never understood the difference either, but it is a

very big one.

Medicaid is health care that has nothing to do with what you contribute in- It is federally funded care supplied to people who haven't got the means to pay any other way. I've been on it in the past- Often it covers maternity care, which is really appropriate- Medicaid is usually paid out through state agencies- If you need care, and don't have the funds to get care, you'd be refered to apply for Medicaid.

Medicare is based on your contrubrutions. I'll never be eligible for Medicare, even if I were to live to retirement age, though I payed in- I didn't work enough "quarters" before I got sick. I could get medicaid again, if I were to let the state put a lien on our house (my only asset) but as a single mom, who is all my kids have left in this world, I'm not willing to do this. I'm trying to get my intrest in the house moved over to my children, but that will not be ignored by the govt- and I'll have to wait several years before I'd become eligible for medicaid again because of that. I understand the government's position- but that doesn't make it any easier.

I wish I could give you more specifics- If you check out your state info page, you should be able to find out what the medicaid eligibility requirements are.

peace~

here is a link I found which might help-

http://www.medicareadvocacy.org/Medicaid_Diff.Vs.Medicare.htm

[busymom]

23. again,

Everything was covered for you...but here is the deal. Medicare negotiates with hospitals and gets an absolute rock bottom price that is only affordable because of those of us with health insurance that make up the difference.

If our entire healthcare system was dependent on a system like medicare it would go BANKRUPT.

[fenriswolf]

25. here is a question

I propose the health industries prices are hyper inflated due to their own insurance bills, their beholding the insurance companies themselves. Every time someone tries to sue a hospital weather it is a legitamite lawsuit or not their own premiums go up. If we had single payer health care I propose the hopital costs themsleves would go down. Granted medicare may not pay as well but I'm sure we can work something out. are you saying we should stay with our HMO's? that single payer wouldnt work? Why is working in europe then?

[busymom]

31. I agree....with some of what you say....

I believe that when everyone has health insurance then costs will go down dramatically because we won't be paying for those with no health insurance who then use the system and can not pay. This is one of the main reasons that a single Tylenol can cost you $15 if you're in the hospital. Prices will go down when everyone is covered.

I also think that there has to be a system of checks and balanced placed on the insurance industry and hospitals to make sure that insurance companies aren't screwing people, doctors and hospitals aren't milking they system and that the patient's care is put first. That will also have to include some kidn of torte reform. One of the reasons that everyone who walks into the ER with a stomach ache gets a CT is to CYA (cover your ass)...not because it is always necessary.

Now...on to Europe...where I lived for nearly a decade of my adult life..in both Germany and Northern Ireland (a part of the UK).

In Germany, the system is set up to allow for anyone to insure themselves either privately or through several different govt. insurance plans. Let me be clear though....everyone is MANDATED to choose coverage and the only way you can choose how much or little you pay is based on whether you choose a private or govt sponsored (but a company) plan.

Individuals insured privately get individual rooms and the kind of care we are used to here. People on the govt plan (like I was when I lived there) get rooms with may people in them and care by resident physicians instead of attendings most of the time. Still...I would have never been denied care for any disease or problem while there.

That system is now in financial difficulty, btw....and the premiums there for both types of plans are expensive enough that many Americans would not be happy with it.

I also lived in the UK.....and though it is a much cheaper system, paid for by taxes (again, not an amount you can choose)....there are extremely long waiting lists and quality of care CAN be an issue. Our good friends from over there had to come to the US to have their 3 year old treated for a kidney condition that they couldn't get care for there....because the child wasn't allowed to see a registrar or a pediatric urologist (too expensive). Sadly, the pediatrician was an idiot...and they had no other recourse.

My husband is a physician who worked in the system and he found it sometimes impossible to get scans for people who really, really needed them immediately. He also experienced being called to a code and the medications not being on the cart ala "sorry, we don't have anymore".

That is something scary to think about.

Healthcare is not free....and I know that you want the best healthcare available when you become ill. Do you want to fight for a PET scan? Wait so long for heart surgery that you die while on the list?

This is a very complex issue...

[fenriswolf]

35. right and my issue with hillary

is we basically have to trust her that health care will be more affordable under her. When we have seen the insurance companies do whatever they can to increase profits. Now I know you cannot deny that health care companies give alot of money to hillary. Now as much of a right the companies have to give donation to a candidate of their choosing I do not think they would give all that money to hillary if they were not expecting something in return.

health care companies would not shoot themselves in the foot like that

With this mandatory now It makes me really leary.

[busymom]

49. She said she would open up the insurance that all of the

congress get to the public.

[fenriswolf]

52. link?

if so why isn't she stating that her healthcare platform is a jumping off point and have plans to convert it into single payer?

[mrreowwr_kittty]

28. Because, silly, insurance companies won't make a shitload of profits.

BTW, I think Obama's plan sucks too.

We need single payer, like Dennis proposes.

[fenriswolf]

30. I agree.

[OmahaBlueDog]

34. Single payer will be a 1 size fits all plan

Allowing private plans to compete will allow more choices for what benefits you want, what you are willing to pay in co-pays/deductibles, and whether or not you would agree to have your rates be raised or lowered based on lifestyle choices.

Not all insurance companies are evil; insurance is based on the premise of shared risk and responsibility; isn't that part of what the Democratic Party is about? However, if you want to get the benefits of capitalism without the profit motive, simply require that all health care insurance compaines be "mutuals." Mutuals are not run for profit, and either reinvest excess income or refund it to the members. Many, many more companies were mutuals until the 90's, when the cost-of-capital got so cheap in the financial markets that many companies de-mutualized, and became stock, for-profit companies. The solution for that is to have government provide cheap capital and not-for-profit reinsurance as a fair exchange for requiring mutualization. The profits are lowered, but the risks are reduced more so.

[Lydia Leftcoast]

51. Not all insurance companies are evil?

Have you ever been middle-aged and self-employed and tried to find a policy that didn't have either

a) crushing monthly premiums ($600)

or

b) deductibles of $5000-10,000?

Then the vulture CEO (all of whom get multi-million dollar annual bonuses, by the way) have the NERVE to write articles saying that they wished Americans were better at scheduling preventive care and tests for themselves.

Well, duh, Mr./Ms. CEO--if a mammogram costs $300 and a colonoscopy costs $1100, it may be hard for YOU, with your multi-million dollar bonus, to figure out why more ordinary Americans aren't having these tests. But with my $5000 deductible, I'm not having these tests, because I don't happen to have disposable income in multiples of hundreds of dollars lying around after expenses are met.

[OmahaBlueDog]

59. Sorry to hear about your situation

<<A) Have you ever been middle-aged and self-employed and tried to find a policy that didn't have either, a) crushing monthly premiums ($600) or b) deductibles of $5000-10,000?>>

I am middle aged and I am not self employed; when I was young, I worked for small companies with no benefits. I know about no insurance, and I know about 80/20 that turns out to be 20/80.

<<Then the vulture CEO (all of whom get multi-million dollar annual bonuses, by the way) have the NERVE to write articles saying that they wished Americans were better at scheduling preventive care and tests for themselves.>>

Well, there's a lot to parse here. First, the truth Americans do need to get more educated about preventitive tests. Second, they also need to get better about shopping the services -- just like any other service. There's no mystery here; doctors & labs aren't terribly different than contractors and mechanics. Third, CEO pay and corporate transparency (read: stockholders have the right to now that the folks up top are taking 100x what the average worker in the company makes) are something that should be a very high priority for the next administration. Fourth, I hear what you're saying about the cost, but your life is worth $32.50 a week (the cost of the two combined tests you just described), and it really isn't even that much when you consider a colonoscopy is 1x every 5 years (BTW - my provider billed out my insurance about $4K for my scope, so if you're getting $1.1K, it's less expensive than some). It is always cheaper to catch cancer early.

I'm guessing you've already looked at small business group purchase options.

Bottom line; whether the government or insurance make the payments, we're asking someone to spread risk and make payments to individuals who have gone to school for 8 + years and perform tests and procedures that are incredibly expensive. The good news is that we live longer in America and cure and treat more diseases; the bad news is that those treatments often require expensive drugs (Cancer), or expensive surgery (heart disease). The money has to come from somewhere. OK -- you want a government plan; you're asking the government to essentially open an HMO. Socialized medicine horror stories and HMO horror stories pretty much sound the same.

One emerging trend: leave the country to go get surgery. The insurance companies haven't embraced it yet, but it's probably coming if a Dem is not elected. It's dirt cheap to get bypass in India or Costa Rica, for example.

[Lydia Leftcoast]

60. Your reality is so far away from my reality that it's not even on the same

continent.$32 a week is a not-insignificant sum. I just had to get new glasses in order to be able to not get headaches while working at the computer, so nothing will happen till I pay off the eye exam and the actual glasses.

You're giving all the Republican talking points about health care, by the way.

[nancyharris]

61. Under single-payer government controlled health plan

who do you think will be paying for your eye exam, eyeglasses and health care?

[Lydia Leftcoast]

64. Depends on the country

But almost everywhere except the U.S., the single-payer system would be paying for my mammogram and colonoscopy.

And it will either be paid for through taxes (yes, TAXES! Run! Hide! Imagine taxes for something besides $3,000 a second for the occupation of Iraq) or income assessments on a sliding scale.

Those are the two models that are found around the world.

None of the international models has a $5000 deductible PLUS monthly premiums PLUS 20% co-pays above $5000.

Are you playing devil's advocate Republican, or do you work for an insurance company, or do you just believe all the scare stories reprinted from British tabloids?

[Texas_Kat]

45. Single payer is the ultimate goal

Did you listen to the last debate?

It's very clear that where she's going....

[BootinUp]

63. Yes, Yes, Yes. nt

[mondo joe]

53. It's not better than single payer. But it is better than the current situation, and

unlike single payer it has a chance of getting through.

[Vinca]

58. If she pushes single payer she won't get insurance company money. nt

[fenriswolf]

62. bingo

do you think they would sink that much money and then expect to be stabbed in the back. As long as she keeps getting funded we will not have single payer. Remember she can always be re-elected so don't look at it in her first term. and I would doubt looking at it in her second term as I am sure she has a great consulting job waiting for her.

[Garbo 2004]

65. Not a "hillerian" but even Edwards, whose plan H's mimics, knew the insurance cos would not allow

themselves to be immediately put out of business.

Both Edwards' and Hillary's plans provide for a gov't plan that would keep costs low and provide subsidies/care for those who cannot afford to pay. Not the ideal, but perhaps within the grasp of the currently possible. Edwards's idea was that the gov't plan would be an alternative to private plans, cracking open the door to eventual single payer. Or was Edwards also in bed with the insurance companies?