The reason why we don't have universal healthcare

[Proud liberal 80]

Is because a lot of Americans are greedy and hateful. They don't want to help out the "others" even if that means that they lose out, too.

[Solly Mack]

1. Yeah. A lot of people are stupid.

They've been conditioned to believe that working themselves to death by age 60 (w/o a living wage and actual health care) is patriotic and incredibly American of them.

[greymattermom]

2. The best description of this I've heard recently is

that some Americans hate blacks more than they love their feet.

[RKP5637]

3. Sadly you hit it, spot on. Greed and Hatefulness in America. In many ways, America is a very stupid

place. Not all, but enough.

[unblock]

4. the underlying reason is it's a competitive advantage for businesses, particularly big businesses

there are people who would retire or otherwise not work, but they need the healthcare that they can't get coverage for as individuals.

there are people who work at big companies instead of small companies or even starting a business of their own because they need the health benefits a big company can provide more efficiently as we've structured the market.


generally speaking, businesses try to focus on their "core competencies" and outsource things others can do better or more efficiently. many businesses outsource things like payroll to companies like adp for just this reason.

no one is in business to buy health insurance, it's no one's "core competency" and it's exactly the sort of things that businesses should want to offload to the government so they can focus on what they're actually in business to manufacture or provide.

and many *small* businesses would, in fact, love this. but big businesses, in particular, like the competitive advantage it gives them, and they have engaged in a major propaganda effort for decades to convince people to keep the playing field tilted to their advantage.

[Freddie]

7. 2 reasons why big business opposes single payer

Even though the majority of employers would save $$$. The most practical way to finance it would be a payroll tax with employer match like Medicare is now; say 7%. 7% of gross wages would be far less than most employers pay in health insurance premiums.
But - 1. They want you chained to your job and 2. They want to be free to pay NOTHING towards health care if they can.

[mac56]

10. Message deleted by DU the Administrators

[unblock]

12. exactly -- direct access to healthcare via the government strengthens workers' negotiating position.

[mac56]

14. Message deleted by DU the Administrators

[taught_me_patience]

5. There is a lot more to it than that

There are entrenched interests in the current system. My wife is a doctor and universal single payor would probably bankrupt her business. We've invested over 200k and five years building it... is it hateful to not want to see your business destroyed? I work for a large medical group. If we had universal single payor, I'd be out of a job... is it hateful to not support something if your livelihood depends on it?

[Freddie]

9. If single payer paid providers fairly

Why would it put doctors out of business?

[taught_me_patience]

17. It won't. I prefer to have a competitive marketplace determining the pay for doctors

In no other private industry does the government control pay like single payor would. I'm not comfortable with that. FYI, I'm for a more robust version of the ACA... so I do support a form of universal health insurance.

[KatyMan]

19. But that free market approach

bankrupts and kills people.

[HughBeaumont]

20. I'm not comfortable with people getting bankrupted due to exorbitant medical costs.

[procon]

36. Very few doctors are in solo practices today,

the management and overhead costs make it just too expensive. They can't provide a competitive benefit package to attract and retain a top staff, and they can't afford the expensive equipment and trained technicians that are routinely available in most full service clinical settings.

Large, for profit clinics have replaced the independant family doctor. They are not a 'private industry', but huge publically traded corporations with shareholders demanding bigger pay offs every year. Before Obamacare the administrative costs vs actual patient care was whatever those companies said it was, and the patients got less so the profits got bigger... I'd be more wary of that.

The fallacy of a 'marketplace' and affordable healthcare is a great hoax. Whether a corporation pays the doctor the salary or the check comes from some government agency, they both are going to try to cut costs, but only one of them diverts money from sick people to rich people. Non-profit is the only logical solution.

[Raster]

11. So people should die? Other countries that have instituted single payer have no problem paying...

...their doctors quite comfortable wages.

IT'S ALL ABOUT GREED. And yes, it is HATEFUL to not want to see your business destroyed when it makes it's money on the suffering of others.

We could re-engineer the healthcare system to work for everyone and at fair prices and save our country a bunch of money, except, the greed gets in the way.

[hunter]

21. Your wife doesn't hate insurance companies?

She's okay with practicing assembly line medicine at their behest?

She likes being told how to do her job by people who don't have her education or experience, people who may not have any medical experience at all but reading what the insurance company computer tells them?

And why would you be out of a job? Do you do insurance billing? If you do, doesn't it frustrate the hell out of you? If you don't, what is it about your job that makes it so you would deal with fewer patients when more patients are able to seek appropriate medical care?

Most of the doctors I know favor single-payer and similar proposals. I think they'd rather meet new patients who are generally healthy with one or two complaints and prevent the sorts of medical train wrecks who first seek care in the Hospital Emergency Room.

[Raster]

23. I have multiple friends and relatives in the medical profession... ALMOST ALL OF THEM say...

...they would prefer a fairer, more accessible Universal Healthcare System that benefits everyone. One Counselor/Therapist I know went back to her old pre-medical profession because she was sick and tired of insurance companies mandating treatments based not on need, BUT ON GREED.

No coincidence that most of the persons I know in the medical professions got into medicine to help people, and to make a difference. Those persons that disagree with Universal Healthcare --by their own admissions-- got into medicine FOR THE MONEY.

[hunter]

32. Medicine, especially primary care medicine, is a job with a high burnout rate.

Teaching, nursing, primary care physicians... all the altruistic professions are severely abused in a political system that rewards greed with "success."

Teaching a kid to read, keeping a very elderly person comfortable in their final days, helping someone control their diabetes... none of that matters. Success in our society is measured by the size of the money stream one controls, as an individual or as corporate officer.

Somewhat alarmingly, "burned out" doesn't have to mean "finds another job." We've all met teachers, nurses, or physicians who are merely going through the motions, who've lost the enthusiasm and idealism they had when they started.

[taught_me_patience]

39. She doesn't like insurance companies but doesn't like medicare as well

Medicare almost mandated the use of electronic records, which has increased charting time by 3-5 min/patient. That's an additional hour of work/day and isn't compensated by rising reimbursement

Medicare gave a 20,000 incentive to convert to electronic records, then performed a HIPAA audit and clawed some of it back. Not one doctor that I know of that has been audited could pass.

MACRA has made it impossible for small practices to compete

Medicare once delayed payments for months because of an error in an address on file.

Back to your questions:
-She doesn't practice assembly line medicine. Assembly line medicine is what Kaiser does.
-She understands complete freedom to do anything she wants is not practical.
-I'll lose my job because the company I work for will cease to make money. I'm one of those "MBA" business guys actually trying to make medicine more efficient.
-It really depends on the doctor. Nowdays, the doctors that go into private practice are truly the elite. They believe in themselves and believe they deliver higher standards of care than assembly line doctors like the ones at Kaiser. Those doctors tend to not prefer single payor.

[hunter]

40. Your wife won't be able to hold back the tide against electronic records. Sorry.

My own doctor was considering chucking it all, telling the insurance companies he was done with them, to build a concierge practice. But he didn't go that far. Now I think he's just counting the days until he can quit coming to work five days a week. Private practices these days are not built and sold, rather they evolve and the partners change.

The insurance companies don't exist to make medicine more efficient. All they really care about is the size of the revenue streams they control. "Profit" or "non-profit," it doesn't matter.

I'm living in the eye of the hurricane here in California. I don't believe MBA business types have anything to say about appropriate medical care. In medicine "efficiency" is meaningless on any scales of less than a decade or two.

I grew up in the Kaiser system, it was one of my dad's union benefits. Kaiser wasn't horrible. In fact, private medicine and "good" insurance might have done me greater harm as a child. I was born with some issues. I once had a specialist whose eye's lit up and he said "Oh! I read about you guys!" when he first met me. Turns out I wasn't in the aggressively treated group, but I wasn't in the placebo group either. I got lucky both ways. Unfortunately that was just the first "pre-existing condition" I've experienced, like shit falling out of the sky, the sort of shit that can fall on anyone. I'm not a hypochondriac, I hate seeing doctors, and I don't generally complain to anyone, especially to my wife who has endured worse random shit. My wife is a medical professional, I've worked in medicine on and off. (When we met we were science teachers.)

I'm a hard core supporter of evidence based medicine, of the sort that's rarely lucrative.

Overall, U.S. medicine is pretty crappy and unreasonably expensive and it doesn't matter how wealthy you are or how "good" your insurance is. There's always somebody trying to sell you something that's not the best thing, not the appropriate thing, and not the evidence based level of care.

[Raster]

6. that is the secondary reason...

...the number one reason we don't have universal healthcare is because parasites that feed off of our healthcare system spend a fortune lobbying (bribing) Congress to limit universal healthcare. Medical insurance for-profit spends literally a fortune every year bribing Congress --BOTH PARTIES-- to curtail and silence any talk or possible universal healthcare legislation. Big pharma also spends a fortune bribing Congress every year to ensure their drug prices are as high as possible and the government is not able to bid on drug prices or bulk buy, thus making sure prices remain high. And to boot, big pharma stands ready to petition the FDA to allow them to continue high pricing by delaying uber-profitable drugs from going generic.

[mac56]

8. This.

[Orsino]

13. Because we let them buy our democracy while we were napping.

Government was in their way, so they paralyzed it.

[zipplewrath]

15. It won't work in the US

At least that's what Obama told me.

[Raster]

16. It won't work with the medical system as currently structured...

...BUT WE CAN CHANGE THE SYSTEM.

Of course, some of the ENTITLED will fight tooth-and-nail to maintain their OBSCENE profit margins and some providers will do anything NOT TO ROCK their cushy financial boats.

[workinclasszero]

18. It's because the religious reich thinks the sick and the poor are cursed by God

so why should they lift a finger to help them? Totally against the teachings of Christ as well but they justify their heresy every Sunday.

It's an unholy mixture of Ayn Rand, the Prosperity gospel, disaster capitalism and plain old greed and racism, IMO.

[thucythucy]

28. The flip side of that is that

certain religious institutions and leaders would prefer that sick and disabled people come to THEM for care, which gives them a chance to push their faith on others. I've heard it said that, if you're in certain sections of the country, and you think you might become ill or poor, the best thing you can do is join a church. Single payer would eliminate that incentive that pushes some people to "seek Jesus."

[workinclasszero]

30. Probably true

I am a believer in Jesus and the right of all people to believe in whatever they want to.

Also for separation of church and state for the good of all the people. IOW a "Godless" democrat!

[mahina]

22. That and a campaign finance system that is legalized bribery.

[workinclasszero]

25. Right

Unrestricted secret campaign money = free speech will be the death of democracy.

[Jim Lane]

24. No, polls show widespread popular support for single payer

The more important reason, mentioned by others in this thread, is the campaign contributions from economic interests that benefit from the current system. The incentives on legislators are not in accord with what their constituents want or need.

[meadowlander]

26. 70% of Americans support "Medicare for all"

We don't have universal healthcare because the for-profit health care, pharmaceutical and insurance industry has bought off the majority of Congress.

[Goodheart]

27. If this were an all white country we would have had universal health care a LONG TIME AGO.

This has very much to do about keeping a caste system based on race and not wanting to share with the "lower" classes.

[thucythucy]

29. Seen this on a bumper sticker:

"Republicans are why we can't have nice things."

[msongs]

31. the #1 reason we dont have universal health care is squandering our wealth on the military, which

HAS universal health care for its own. go figure nt

[LittleGirl]

33. we don't need universal healthcare,

we need single payer like the rest of civilized world. Single payer is the way to go.

Universal healthcare is what we have now and it's too expensive because of the profit motive in this country.

Single payer is NON-PROFIT and the only method of delivering healthcare to citizens of all stripes.

[SCantiGOP]

34. The reason we don't have it

Is very simple: in the current system, 30 cents of every healthcare dollar ends up in the pocket of insurance companies.

I remember learning years ago that it is a fallacy to think it's the banks that have all the money. When they need to borrow or be underwritten they turn to the deep pockets of the insurance industry.

[Demsrule86]

35. I don't agree.

It is complicated but if we save the ACA...we reduce premiums by lowering the age of Medicare gradually...eventually everyone is on Medicare.

[IthinkThereforeIAM]

37. Of course...

... one really notices that out here in South Dakota. They ridicule those they consider, "beneath them". And in turn, if by some act of fate, one of those, "beneathers", gets to move up (inheritance, etc...) they in turn look down on their old next door neighbors.

[Yavin4]

38. What's even crazier is that racists in other nations still would keep their healthcare.

As racist as they may be, LePen's and Brexit followers still want to keep their national healthcare.