Single payer is only two thirds as expensive as the private insurance industry

[applegrove]

that the US has now. All those rich people complaining about their tax dollars going to pay for healthcare for the less well off will have to pay 1/3 less than they do now for each person's health care their tax dollars cover now. They could cover more people. It would cost less in taxes on corporations than it costs corporations to cover their employees with health care. What is so bad about that?

[ck4829]

1. Health care in the US isn't about money (Or even about treating people), it's about social control

Excluding people that people in charge don't like from access (The poor, but also other groups)
Blaming the victim
Delegating morality
Marginalization
Constructing class, race, and gender through the different ways of access and outcomes
Coercing people to have access to insurance through work... which means they will work at a job that may be grueling and takes time away from other things so they can have a chance at access to health insurance
And more

http://tpalladium.freeforums.net/thread/19/intro-evidence

Money is secondary IMHO.

Now this is not to say it's a giant conspiracy, this is something on the macro scale outside of us; doctors, nurses, and employees of hospitals do great jobs, and also the ACA mitigated some of this social control.

Real health care reform means valuing treating people over social control.

[Hortensis]

20. We have "revolutions" every 4 or 8 years or so in hundreds of governments,

federal, state and local in our system of very decentralized governance. You're certainly right that there is no giant conspiracy.

This is "social control" in the same way not requiring apartment houses to provide laundry facilities is social control, in that lack requires people to go use commercial facilities, or friends', or go dirty. There is also not a giant conspiracy across those hundreds of state and local governments to keep low-income people too tired to read and to support local laundromats.

There are, however, consequences to everything and costs and benefits to everything, and often more pull one way than another, especially down the lower the incomes go.

[democratisphere]

2. The wealthiest want the additional 1/3 cost in their pocket AND

and they don't give a sh't about ANYONE's health or care but themselves.

[Demsrule86]

3. And what does it matter? The single payer bill will not pass...and I doubt it

is less expensive for those who have workplace insurance. People who have workplace insurance will not give it up in order to have single payer and pay more taxes...they are subsidized by employers remember. This is what killed Hillarycare when all was said and done. You can get to universal coverage like Germany or Switzerland...but not single payer. And if we run on it in 18 and 20 we lose...the GOP demonizes it and snatches a win out of the jaws of defeat. We have to have realistic policy goal that is achievable. The GOP can not demonize the ACA...and if we run on stopping the GOP from destroying it, we could get back the House and maybe the Senate...but not if we run on single payer...already they are getting a CBO score to use it against us. Save the ACA...because if it goes down...it could be years before we get anything.

[Madam45for2923]

9. I think I will add the word "single" to words I block here!

[Paka]

11. Merci!

Not a bad idea!

[Demsrule86]

12. I get that...I just don't want millions to lose health care and the ACA be repealed...

The GOP are preparing to mount a campaign against the ACA using the single payer bill.

[Madam45for2923]

13. Yep, that was predictable. UGH!

[JCanete]

18. seriously? That would be the weirdest campaign ever. I'll believe it when I see it. nt

[Turn CO Blue]

16. You're making some inaccurate assumptions. Most workplaces don't subsidize very much

and the premiums for workers over 45 or 50 are astronomical even when you're in a fantastic group plan at a large employer.

My husband's company only pitches in $400 - that still leaves us with a $1400 premium per month (for two people in their 50s).

Please talk to several people in their late 40s or 50s. that is a challenge. You'll find almost ALL of them are in the same situation - paying over 1/3 or 1/4 of their income for medical insurance premiums, even if they're in a very large group plan.

on edit - edited to attempt to take all the emotion and drama out of my response.

[white_wolf]

29. It's not necessarily better in your 20s or 30s.

So many employers are moving to contract labor solely to avoid given benefits like health insurance. Personally, I don't expect the workplace model to last too much longer. There are too many loopholes.

[VMA131Marine]

28. Between my employer and myself, the cost of my insurance is $18k/yr for a family of three

with a $7k deductible. My employer pays about 2/3rds of the cost of the insurance. So that's $25k before I get a dime in coverage from the insurance, except for annual physicals, which are free. If single payer cuts that amount by a third, I don't see how that isn't a win for employer and employee even if we are both now paying that as a tax to the government.

[Le Gaucher]

4. So doctors, nurses and phama is going to see a 25% revenue cut

( the remaining I guess is insurance margin) while providing care to a lot more people.

At least that is how they will see it as and raise a stink

[applegrove]

5. No. There will be more people going to get health care more often.

[Le Gaucher]

6. Unless the case is made that staff required to do billing and other admin

Will offset the revenue loss .. This is going to be a very hard sell

[applegrove]

7. Part of the savings is in preventive medicine. People don't get so sick.

They shape up.

[brer cat]

14. Who is going to provide that preventative care?

We have a shortage of primary care providers now and you are anticipating a huge increase as more people receive "free" care. Many physicians now refuse to accept Medicare patients or limit the number they see because of low reimbursements. How will they react if all of their patients have that low reimbursement? What about the incentives for medical students to spend the enormous time and money required to get a medical degree if they see sharply reduced earnings or else a huge increase in workload to make up the difference? How is this factored into the rosey scenario you paint?

What about the displacement of millions of people who work in the healthcare insurance industry and in physician offices and hospitals processing payments? Do you think there will be a cost to taxpayers for these lost jobs and if so, how is that factored into the savings of single payer?

I am all in favor of universal healthcare, but I don't see the people pushing for single payer to be implemented in a relatively short time addressing all the issues.

[Hassin Bin Sober]

17. why do you assume the Medicare reimbursement rate will remain the same for everyone as it is now?

Is there evidence to that effect?

I would hope we could improve on Medicare seeing as though we would bring in millions of healthy rate payers.

It doesn't make sense to keep a for profit system that extracts 25-30% in profit and overhead your entire working life when you don't (statistically) need the insurance. Then turn around and pawn everybody off on the government when you are sick and elderly.

[brer cat]

21. The OP stated that single payer would be 2/3

of the cost of private insurance without giving one iota of supporting data. It is his OP, let him provide the basis for his calculations.

Additionally to your statement, it will also bring in the millions who have had no or minimal care for decades because they can't afford the current system. What makes you assume they are healthy? Do you have any evidence to that effect?

I am totally in favor of universal healthcare but there are many issues that have to be evaluated and potential problems solved before we get there. Tossing out pie-in-the-sky figures with no basis does not make good policy or a very convincing argument for change. It's not just "rich" people who are going to be complaining about their taxes going up and we need to have realistic facts and figures if we are going to get support for throwing out their existing coverage.

[Hassin Bin Sober]

24. I'm talking about working 20, 30 and 40 year olds with current for profit insurance.

Those people haven't gone untreated for decades. They, or their employers, pay for care they mostly don't use.

Do I really need to show you statistics that 20 and 30 year olds are healthier than 70 and 80 year olds?

And we do already treat those uninsured and "untreated" people. Only we do it in the most expensive way imaginable. In the ER when they are very sick.

[applegrove]

26. 2/3 per person covered. More people covered for what the US pays

across the board today for all healthcare today. More than any other western country with some form of single payer or universal health care.

[pnwmom]

23. And if Medicare reimbursement goes significantly down, so will salaries. Look at relative salaries

between doctors in the US and in systems with national health care. Ours are significantly higher.

[applegrove]

25. Very, very qualified people get turned down for medical school in Canada every year.

It is a calling. Also if people have fewer chronic conditions their heslth care needs go down.

[pnwmom]

22. Doctors already have full days. We will have to train more doctors, and that will raise costs.

We can't switch all doctors from 10 minute appointments (or whatever) to 5 minute appointments.

[Hassin Bin Sober]

30. So what happens to those same doctors if we "fix" the ACA and actually cover everyone?

The arguments in this thread reek of social Darwinism.

We don't have enough doctors so let's keep a system that skims 30% in profit and overhead because we really can't cover everyone.

When we fix ACA and cover everyone, who is going to pay for the increased training? Or is the for-profit insurance industry going to shit them out?

Makes total sense.

[pnwmom]

31. Uh, no. The ACA already reduced overhead to no more than 20% and single payer should lower overhead

to Medicare levels, probably.

I'm not arguing that the current system is preferable or even sustainable.

HOWEVER, they will still have to take a chunk out of doctor's salaries, IF they're going to bring costs in line with other countries.

I'm not advocating shutting anyone out. I'm saying that it is going to be more expensive than people realize because of the structure we're starting out with -- doctors who spent hundreds of thousands of dollars putting themselves through medical school in exchange for the high salaries they receive.

We might decide it is better to fund doctors' educations, so we end up with good doctors who are willing to work for lower salaries.

[Hassin Bin Sober]

32. If you believe that BS about 20% I have a bridge to sell you

Anyone who's ever worked for a for-profit company on a government contract based on time and materials knows exactly how that gets gamed.

This overutilization bullshit that the right-wing is trying to Peddle is just that, bullshit. Who are all these people that just want to go to the doctor for no good reason?

And I have news for you, the people that are uninsured - they still go to the doctor. We still treat them. Doctors still treat them. Right now! Only they do it in emergency rooms or dialysis clinics because they didn't go to a family care physician and find out they had high blood pressure or diabetes. Or they knew they had diabetes but didn't go to the doctor because they couldn't afford co-pays and Medicine.

We just pay a shit ton more to treat these people after they get really sick

Or high school friend of mine who didn't go to the doctor when he dropped something on his toe and didn't realize it was diabetic ended up in the hospital for 3 months and is now on permanent disability and pees into a bag. We sure dodged a bullet with his overutilization. Only we had to pay for about a million dollars in surgery in a lifetime of disability and now Medicaid

[area51]

34. +1 n/t

[brer cat]

33. Juvenile taunts and sarcasm won't sell your position.

I haven't read anyone posting here that wants to continue the status quo. I would guess that we are all committed to achieving universal healthcare. However, many of us recognize that there are serious obstacles to single-payer that we don't see being addressed especially in a bill that would make the change-over in a relatively short time. But it is obviously a waste of time in this thread.

[Warren DeMontague]

36. Yes theres clearly a huge problem some have with the single payer proposal in the senate

Gee, i wonder what it could be!

[bucolic_frolic]

8. Everything is about risk

Lloyd's of London understood that. There is risk in everything, and managing risk while being paid for it is the essence of insurance companies. The world has very few successful experiments in socializing risk to eliminate the need for private underwriting. It could be we are at such a moment. Too big to fail? Too little to worry about. Collective human intellectual and productive capital could make insurance not worth the time.

[dogman]

10. It reminds me of driving in traffic.

There are people who would run you and your family in to the ditch to gain one car length ahead of you. They will reap the rewards of your financial destruction to gain a few years longer to get to the cemetery with more wealth than you. They are like the Pharaohs who would bury all of their wealth with themselves.

[JCMach1]

15. But but but freedom or something

[Orsino]

19. That is why They don't want us to have it.

The bigger the expenditures, the more They can steal from us.

[Hortensis]

27. It's far cheaper and very good, but don't forget to add on medication, dental, eye,

and other needs that Medicare A and B (a really necessary but voluntary supplement that recipients have to purchase), for instance, do not cover. And don't even think of Part A alone if you're not well to do but do have assets, like a home, to protect from illness-induced destitution. Medicare's great as far as it goes, but that's the route to spending one's last years in an SRO (single-room occupancy).

[Warren DeMontague]

35. But I was told I dont understand math- because I dont see why giving for profit insurance companies

A 20% overhead is WAY WAY CHEAPER because a single payer system will add scary new costs because we will have to PAY FOR IT and it is NOT FREE and people will even GO TO THE DOCTOR MORE which means that this soooper economical system weve got now will suddenly get a trajilliommiillionbazillion dollars in new extra costs so WAY TOO EXPENSIVE because MATH!!!!!!!