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Wed May 24, 2017, 11:29 AM

Dem lawmakers call for single-payer healthcare

Source: The Hill



BY PETER SULLIVAN - 05/24/17 11:21 AM EDT

A group of House Democrats called Wednesday for a single-payer, “Medicare for All” system amid Republicans' ObamaCare repeal push.

The roughly half a dozen Democrats were led by Rep. John Conyers (D-Mich.), the longest-serving member of the House, who has for years sponsored legislation to create a single-payer healthcare system that would see the government provide health insurance for everyone.The lawmakers attacked Republican efforts to repeal ObamaCare, but argued that the country needed to also go further than the current health law.

“We can fight fiercely to protect the Affordable Care Act and also look a little bit farther in terms of establishing Medicare for All,” Rep. Keith Ellison (D-Minn.), a high-profile single-payer advocate and vice-chairman of the Democratic National Committee, said at the press conference.

Conyers touted that his Medicare for All bill now has the most co-sponsors it has ever had with 111 lawmakers — more than half of the House Democratic caucus. The chairman of the House Democratic caucus, Rep. Joe Crowley (D-N.Y.), joined as a co-sponsor of the bill earlier this week. “I’ve never seen more energy behind this issue of Medicare for All,” Conyers said.

Read more: http://thehill.com/policy/healthcare/334917-dem-lawmakers-call-for-single-player-healthcare

76 replies, 12131 views

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Arrow 76 replies Author Time Post
Reply Dem lawmakers call for single-payer healthcare (Original post)
DonViejo May 2017 OP
still_one May 2017 #1
kristopher May 2017 #3
mountain grammy May 2017 #10
Wounded Bear May 2017 #2
KPN May 2017 #4
erronis May 2017 #8
PoindexterOglethorpe May 2017 #16
erronis May 2017 #21
ehrnst May 2017 #35
MiddleClass May 2017 #69
ehrnst May 2017 #25
erronis May 2017 #28
ehrnst May 2017 #34
kristopher May 2017 #41
ehrnst May 2017 #44
kristopher May 2017 #45
ehrnst May 2017 #49
kristopher May 2017 #51
ehrnst May 2017 #61
kristopher May 2017 #63
ehrnst May 2017 #64
kristopher May 2017 #65
ehrnst May 2017 #66
Fantastic Anarchist May 2017 #14
Ligyron May 2017 #5
Maxheader May 2017 #6
ehrnst May 2017 #26
Maxheader May 2017 #36
ehrnst May 2017 #38
Maxheader May 2017 #72
ehrnst May 2017 #73
kristopher May 2017 #75
FairWinds May 2017 #7
Scarsdale May 2017 #9
progree May 2017 #19
ehrnst May 2017 #23
progree May 2017 #30
MGKrebs May 2017 #11
ehrnst May 2017 #24
TomCADem May 2017 #12
Fantastic Anarchist May 2017 #15
Fantastic Anarchist May 2017 #13
ehrnst May 2017 #22
Fantastic Anarchist May 2017 #27
ehrnst May 2017 #32
FairWinds May 2017 #17
burnbaby May 2017 #18
MiddleClass May 2017 #70
ehrnst May 2017 #20
Fantastic Anarchist May 2017 #29
ehrnst May 2017 #33
Fantastic Anarchist May 2017 #39
ehrnst May 2017 #40
Fantastic Anarchist May 2017 #42
ehrnst May 2017 #43
kristopher May 2017 #46
ehrnst May 2017 #48
kristopher May 2017 #50
Fantastic Anarchist May 2017 #54
ehrnst May 2017 #56
ehrnst May 2017 #57
Fantastic Anarchist May 2017 #53
ehrnst May 2017 #55
Fantastic Anarchist May 2017 #52
ehrnst May 2017 #58
Fantastic Anarchist May 2017 #60
ehrnst May 2017 #62
kristopher May 2017 #47
ehrnst May 2017 #59
kristopher May 2017 #67
ehrnst May 2017 #68
MichMan May 2017 #31
ehrnst May 2017 #37
kristopher May 2017 #71
ehrnst May 2017 #74
kristopher May 2017 #76

Response to DonViejo (Original post)

Wed May 24, 2017, 11:33 AM

1. While this is all well and good, it means very little unless we win in 2018

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Response to still_one (Reply #1)

Wed May 24, 2017, 11:40 AM

3. It's part of the path to winning in 2018.

People *are* paying attention.

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Response to kristopher (Reply #3)

Wed May 24, 2017, 02:08 PM

10. Yes, exacty!

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Response to DonViejo (Original post)

Wed May 24, 2017, 11:34 AM

2. K & R ......for visibility..nt

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Response to DonViejo (Original post)

Wed May 24, 2017, 12:05 PM

4. They should have done this in 2009.

If they had, we likely wouldn't have single-payer, but Obamacare would have been even better and more bullet proof than it is now.

On the other hand, it's good to see this. Whatever it takes to get us to single payer. It's the only sensible solution.

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Response to KPN (Reply #4)

Wed May 24, 2017, 01:26 PM

8. Agree. And I'd like to see a full post-mortem on why we didn't

I know there was bad press, probably hacks from invested interests.

I know big business (insurance companies, PHARMA) fought it because there income is made by skimming/bleeding the patients.

I wonder if something/someone didn't get to the Clintons to make them back off.

Politics and profits are such ugly bedfellows.

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Response to erronis (Reply #8)

Wed May 24, 2017, 02:31 PM

16. Single payer was off the table from the very start.

Lots of people were extremely angry about that, but earnest Democrats like Nancy Pelosi thought it was just fine to not consider single payer at all.

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Response to PoindexterOglethorpe (Reply #16)

Wed May 24, 2017, 03:38 PM

21. Yes, I remember. Max Baucus seemed to be sitting on it and shut down the inclusion

I still don't think I understand why this happened.

I can accept rational arguments about funding, support, etc. These are perceptions and may be anecdotal.

I've read "America's Bitter Pill" about the battles that raged during the ACA.

Still, I would guess there are a lot of other reasons that caused the total lockdown on discussions of single-payer, universal healthcare, etc.

------

I had to go back and refresh my limited memory cells from 8 years ago. I think I remembered correctly
Max Baucus - Wikipedia


Opposition to single payer health care[edit]
Advocate groups attended a Senate Finance Committee meeting in May 2009 to protest their exclusion as well as statements by Baucus that "single payer was not an option on the table." Baucus later had eight protesters removed by police who arrested them for disrupting the hearing. Many of the single-payer advocates said it was a "pay to play" event.[39][40][41] A representative of the Business Roundtable, which includes 35 memberships of health maintenance organizations, health insurance and pharmaceutical companies, admitted that other countries, with lower health costs, and higher quality of care, such as those with single-payer systems, have a competitive advantage over the United States with its private system.[42]
At the next meeting on health care reform of the Senate Finance Committee, Baucus had five more doctors and nurses removed and arrested.[43][44][45] Baucus admitted a few weeks later in June 2009 that it was a mistake to rule out a single payer plan[46] because doing so alienated a large, vocal constituency and left President Barack Obama’s proposal of a public health plan to compete with private insurers as the most liberal position.[46]
Baucus has used the term "uniquely American solution" to describe the end point of current health reform and has said that he believes America is not ready yet for any form of single payer health care. This is the same term the insurance trade association, America’s Health Insurance Plans (AHIP), is using. AHIP has launched the Campaign for an American Solution, which argues for the use of private health insurance instead of a government backed program.[3] Critics have said that Medicare is already effectively a single-payer system.[47]

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Response to PoindexterOglethorpe (Reply #16)

Thu May 25, 2017, 09:00 AM

35. Yeah, I feel the same way when people say that Dems need to take women's health care off the table

 

to appeal to white male midwesterners.

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Response to PoindexterOglethorpe (Reply #16)

Fri May 26, 2017, 05:52 PM

69. Nancy Pelosi had a public option in the house bill, Senate did not, then Kennedy died

I believe the house bill passed, the Senate bill passed, it was on its way to the conference committee where they put the two bills together into one bill. Then, both parts of Congress have to pass the same bill before it goes to the president. Kennedy died, then Democrats could only get 59 votes, in the Senate until his replacement. Brown, 41 (41 vote to sustain Republican filibuster)

. The only way around Republican filibuster was for the house to vote on the Senate bill that already defeated the filibuster. So Nancy Pelosi, who was a staunch supporter of the public option, swallowed her pride and save Obama care.

She should be thanked, not vilified.

Plotkin Joe Lieberman was the one who is the one responsible for no public option from the Senate bill

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Response to erronis (Reply #8)

Wed May 24, 2017, 03:52 PM

25. Here's a good overview of why we didn't

 

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Response to ehrnst (Reply #25)

Wed May 24, 2017, 04:00 PM

28. Thanks - but I think this points out that the $$$d interests own the conversation.

From that KHN link:

The U.S. health care system, said Jeff Goldsmith, a health care consultant and health futurist, is “the size of a country — it’s bigger than France — and it employs 16 million people.”

In moving to a single-payer system, he said, “you’re talking about reallocating $3 trillion, reducing people’s incomes and creating” in effect a single entity that would set prices for all medical services. Single-payer supporters dispute the idea that getting from here to there could not be done.

“We’re so used to such a complicated system in the U.S. that we envisage any change would be incredibly complicated as well,” said Steffie Woolhandler, a physician and one of the founders of the single-payer advocacy organization Physicians for a National Health Program. “But what you’re doing with single-payer is actually simplifying the system.”


Does that mean we shouldn't try to realize these cost savings?

Does that mean that we should continue to pay the administrative/CEO costs of insurance companies that do nothing except get in the way of healthcare?

It's a pretty poor excuse for not trying - "It'll disrupt a lot of rich people's incomes."

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Response to erronis (Reply #28)

Thu May 25, 2017, 08:54 AM

34. That was never stated in the article, nor implied.

 

You created that implication.

You are implying that the only people who would be affected negatively in completely rebuilding how health care is paid for will be "a lot of rich people," because of a misreading of two statements.

There will be far more "disrupted" than "rich people's incomes."


Perhaps you skipped this:

"And it’s not just the private insurance industry (which would effectively be put out of business) that could feel the impact to the bottom line. Parts of the health care industry that lawmakers want to help, like rural hospitals, could inadvertently get hurt, too. Many rural hospitals get paid so little by Medicare that they only survive on higher private insurance payments. Yet under single-payer, those payments would go away and some could not make it financially. “You would not want to wipe out a third of the hospitals in Minnesota by accident,” Pollack said. “And you could,” if payments to hospitals end up too low."

And this:

"Both Starr and Pollack, however, said it would be possible to make a switch, although it would have to be carried out over a very long period of time.

“You could imagine some kind of long transition, where you gradually expanded Medicare,” said Starr, “for example moving it down to age 55” and then in later years continue to lower the age threshold."

HRC's plan was to allow people to buy into Medicare at 55, then expand children's coverage. This allows a gradual conversion of payment mechanisms, and a gradual expansion of the infrastructure needed in the Federal Government.

Even Bernie Sanders acknowledged in the debates that single-payer health care is not politically feasible in the foreseeable future and has said that it is unlikely without, among other things, campaign finance reform first.

Canada didn't go to a federal single payer system until all the provinces had done so independently, which took over 20 years. With Vermont single payer failing, and Coloradocare being defeated last November, we aren't going to do it the way Canada did.

Changing anything that is such a huge portion of the GDP is going to take time and money - as with any major project, "Cheap, fast or good - pick two."


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Response to ehrnst (Reply #34)

Thu May 25, 2017, 11:29 AM

41. That's a bunch of hooey

EX: "Parts of the health care industry that lawmakers want to help, like rural hospitals, could inadvertently get hurt, too. Many rural hospitals get paid so little by Medicare that they only survive on higher private insurance payments. Yet under single-payer, those payments would go away and some could not make it financially. “You would not want to wipe out a third of the hospitals in Minnesota by accident,” Pollack said. “And you could,” if payments to hospitals end up too low." "

Sure, "you could" "wipe out a third of the hospitals" in Minn. but you wouldn't because the program would, by necessity, address the problem.

You have a real bad habit of posting bunk that is, by design, nothing but a defense of an indefensible for-profit insurance system.

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Response to kristopher (Reply #41)

Fri May 26, 2017, 11:23 AM

44. Now there's a reasoned, intellectual response....

 

You sound just like the anti-vaxxers when one points out the evidence that vaccinations are safe.

"You're just defending big pharma/insurance industry!"

So tell me, what other "bunk" that I have posted has gotten under your skin?

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Response to ehrnst (Reply #44)

Fri May 26, 2017, 12:33 PM

45. Yes, it is a well reasoned, intellectual response.

Hooey is a long standing and respected academic term describing the claims of a fraud or charlatan.

When you used this suppositional construction as an example of why single payer isn't able to work here you were definitely engaged in slinging hooey.

Quote:
""Parts of the health care industry that lawmakers want to help, like rural hospitals, could inadvertently get hurt, too. Many rural hospitals get paid so little by Medicare that they only survive on higher private insurance payments. Yet under single-payer, those payments would go away and some could not make it financially. “You would not want to wipe out a third of the hospitals in Minnesota by accident,” Pollack said. “And you could,” if payments to hospitals end up too low."
End Quote

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Response to kristopher (Reply #45)

Fri May 26, 2017, 01:55 PM

49. Um.... That was the argument of the person in the quote using that "suppositional constructon."

 

I related this from an article from a reputable source for information.

Sorry it disturbed you so much.

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Response to ehrnst (Reply #49)

Fri May 26, 2017, 02:07 PM

51. You presented that suppositional argument as representing your view.

It presents an area of concern that would be addressed by final system design as an obstacle that discredits single payer. It's baseless scare-mongering.

It is also typifies your entire approach to the discussion...

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Response to kristopher (Reply #51)

Fri May 26, 2017, 04:34 PM

61. I'm presenting information from a well-sourced article

 

If that specific point makes you angry, I suggest you direct that anger at the author of that point.

What typifies your approach to the entire discussion is anger, and accusations that are unfounded.

If evidence and reliable journalism on health policy is threatening to you, perhaps you need to evaluate the source of that anger.

If that's not possible, I suggest the "ignore" feature to preserve your peace of mind.

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Response to ehrnst (Reply #61)

Fri May 26, 2017, 04:49 PM

63. More with the personal attacks?

I explained the specific problem with the specific argument you chose to share as representing your beliefs.

Your reply only makes sense as an admission that you have neither a direct answer to my clear comments on the validity of the argument you've made, nor a well reasoned explanation of how my criticism is not on target.






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Response to kristopher (Reply #63)

Fri May 26, 2017, 04:54 PM

64. You haven't presented evidence that your criticism is supported by data

 

Which is fine, as long as you own it. But you haven't.

As the saying goes, "Don't believe everything you think."

Calling something Hooey is hardly supporting your argument.

And pointing that out is hardly "name calling," or a "personal attack."

Again, I suggest the "ignore" feature if someone presenting evidence that challenges your beliefs is that upsetting.

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Response to ehrnst (Reply #64)

Fri May 26, 2017, 04:59 PM

65. It isn't a "data" error - it's a reasoning (false claim) error.

Pretending it is "data" based is intentional misdirection.

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Response to kristopher (Reply #65)

Fri May 26, 2017, 05:11 PM

66. No, not at all.

 

Just saying "it's a bunch of hooey" isn't an actual response with data or some evidence.

Is that clearer?

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Response to KPN (Reply #4)

Wed May 24, 2017, 02:22 PM

14. Fully agreed!

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Response to DonViejo (Original post)

Wed May 24, 2017, 12:07 PM

5. Everybody should call their Rep and tell them to get behind this!

Even if your Rep supported it anyway.

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Response to DonViejo (Original post)

Wed May 24, 2017, 12:17 PM

6. I know nothing..

about the cost of implementing something like that..I only
know that it could be done...for everyone. Nick off those
new subs and new fighter development programs.
How about stuff like the pentagon hording gas and selling
it to the armed forces at exorbitant costs? And trump wants
to sell off parts of our gas and oil reserves? Shove those billions
in trumps budget plan, for a wall..et.al..where the sun don't shine.

single pay? do-able in my opinion.

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Response to Maxheader (Reply #6)

Wed May 24, 2017, 03:53 PM

26. Do you know why it failed in Vermont?

 

Just curious.

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Response to ehrnst (Reply #26)

Thu May 25, 2017, 09:12 AM

36. Why did it fail in Vermont?

Thank you.

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Response to Maxheader (Reply #36)

Thu May 25, 2017, 10:14 AM

38. For several reasons. It's important to know what failed before you can determine what is "doable."

 



1. Green Mountain Care was what would be considered a "platinum" insurance plan, instead of a much more limited plan like Medicare, making it way more expensive than Medicare. What Sanders proposes is more along the lines of what Vermont had, than actual Medicare for all. Medicare does not cover dental, vision, hearing or prescriptions - you have to buy private insurance to cover those.

2. The costs of that plan wound up needing to be covered by an 11.5 percent payroll assessments on businesses and sliding premiums up to 9.5 percent of individuals’ income. Even with the federal government offsetting Medicare and Medicaid patients care, it was still too costly to finance the plan for the rest of the population.

3. It exempted taxes on big businesses that had employees in multiple states - which cut into a major funding stream. That was a huge mistake. If the few big business interests could get exemptions in lefty Vermont, imagine what a lot of them could do in a national debate over this. I'm not defending them. I'm pointing out the reality of the massive political will that would be necessary.

"In Europe, many countries built their universal health care systems from scratch, with some starting early last century when most citizens had no medical coverage and any services provided by governments were welcome, the Brooking Institution’s Aaron said. That allowed those countries to slowly build and expand health care systems over decades.

But in the United States private insurance arrangements between employees and employers have expanded and matured over the decades, with many people with insurance expecting a high level of medical service. So, switching to a single-payer system would need to meet those higher expectations — and higher costs — all at once, Aaron said.

“It’s easier to build from scratch than when a system is already up and running,” he said. “We could have maybe created a single-payer system 60 or so years ago, when insurance wasn’t as complete and widespread. But it would be very disruptive and costly today.”

https://www.bostonglobe.com/business/2015/01/25/costs-derail-vermont-single-payer-health-plan/VTAEZFGpWvTen0QFahW0pO/story.html

The expectations that Americans have for health care coverage make European style health care delivery (such as facilities and clinics that look more like DMVs and government buildings than gleaming new facilities with fountains and atriums) make US citizens think that they are not getting good health care. I lived in England and really loved the health care I got, but I know that my father would have turned his nose up at the local clinic waiting area that needed a coat of paint, had old furniture, and old but servicable medical equipment.

There are so many obstacles in place for overhauling the payer system in the US that aren't taken into account by many people without knowledge of how health care funding and delivery works. Single payer is as "doable" as converting all cars over to plug-in electric in 5 years. A great goal, both environmentally and energywise, but you have not only big oil, but the need for outlets to be as handy as gas stations, and the economy would also need to absorb the effect of all the industry jobs that would be phased out that quickly (drivers that transport gasoline, gas station attendants, refineries, drilling, etc) but the expense of those cars standing in the way of implementation.

I would LOVE solar on all businesses and residences, and know that eventually, the panels pay for their initial expense - but I also know the obstacles. I would not demand legislation that would require all Solar, at the expense of supporting a tax break or federal subsidies for some in the meantime... I think the same about universal health care coverage. Single payer isn't the only way to do it, and could be more damaging than a gradual expansion of subsidized health care coverage.


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Response to ehrnst (Reply #38)

Sat May 27, 2017, 08:59 AM

72. I've had almost



10k dollars of vision care paid for by medicare---

"Medicare does not cover dental, vision, hearing or prescriptions - you have to buy private insurance to cover those. "

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Response to Maxheader (Reply #72)

Sat May 27, 2017, 09:06 AM

73. To clarify: Medicare doesn't cover routine eye exams for eyeglasses or contacts

 

They would, however cover medical procedures on eyes, which is not "vision coverage." I'm pretty sure you didn't spend 10k on routine vision exams glasses or contacts.

My employer health coverage doesn't include "vision coverage" (routine exams and glasses) either, but I was able to get a cataract removed on that insurance.

https://blog.medicaremadeclear.com/How-to-Get-Dental-and-Vision-Care-Coverage-When-You-Have-Medicare/

What did you think of the rest of the post?

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Response to ehrnst (Reply #73)


Response to DonViejo (Original post)

Wed May 24, 2017, 12:57 PM

7. Agree with kristopher . .

 

that this is part of the path to winning in 2018.

It's amazing to me that establishment Dems are so
reluctant to support to a progressive measure that is
backed by 57% of the American people (Gallup), and
a MUCH greater percentage of Dems.

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Response to DonViejo (Original post)

Wed May 24, 2017, 01:40 PM

9. Medications

I do not have Medicare Part D, since I only take blood pressure medications, which WERE $10 for 3 month supply. Today I renewed one subscription, and it has increased to $30 for 3 months supply. Preparing for cataract surgery, I had to get two different eyedrop medications. One little bottle was $172.50 and THAT is the GENERIC price. So my pharmacy bill was $253.00 God help us all when Ryan's new healthcare bill gets shoved down out throats. Fortunately for him and the rest of the gop, their costs will not be going up, they protect themselves from these exhorbitant prices, at taxpayer expense.

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Response to Scarsdale (Reply #9)

Wed May 24, 2017, 03:04 PM

19. Please get on a Medicare Part D plan ASAP -- the penalty far outweighs the premium

As you probably know, there is a penalty for late enrollment in part D -- for 2017 for each month delay in enrolling past your initial enrollment window, your monthly premium goes up by 34.1 cents/month. Sounds utterly trivial, but that 34.1 cents is tacked on every month's premium for life (after enrolling). For someone with a 20 year life expectancy at age 65, that's 34.1 cents/mo * 12 months/yr * 20 years = $81.84. That's the consequence of being just 1 month late.

For someone a year late in enrolling, that's $982 over a lifetime.

Actually, the monthly premium penalty increases with the "national base premium". That's another degree of uncertainty I didn't want to risk. The other risk factor is unexpectedly needing an expensive drug.

A Silverscript plan, just to pick one, and it has no deductible, costs about $32/mo or $384/year. So that $384 saves $982 + inflation, and without even using it.

Anyway, that's one scenario.

----------------------------------------------------------------------------------------------

Another scenario -- someone delays 5 years (and never buys prescription drugs) and then gets a Part D plan and lives another 4 years:

The added penalty per month (*ignoring inflation*) for delaying enrollment by 5 years is: 34.1 cents/month * 12 months/year * 5 years = $20.46 additional per month

Since the person lives only 4 more years after enrolling, that late enrollment penalty is $20.46/mo * 12 months / year * 4 years = $982 over a lifetime.

The Silverscript plan for the 5 years that wasn't needed or used cost $32/mo * 12 mo/year * 5 years = $1920.

So delaying enrollment can work out if one doesn't live very long after getting on the drug plan.

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Response to progree (Reply #19)

Wed May 24, 2017, 03:50 PM

23. Medicare is not single payer, and never has been.

 

The average Medicare recipient pays 15% of their income on medical bills.

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Response to ehrnst (Reply #23)

Wed May 24, 2017, 04:14 PM

30. Fidelity figures a couple both turning 65 needs $245,000 not including long-term care

to pay their medical premiums and expenses.

>> The average Medicare recipient pays 15% of their income on medical bills. <<

I figured it was worse.

Fidelity does an estimate every 2 years -- the below link is for the 2015 study which appears to be the latest.

https://www.fidelity.com/about-fidelity/employer-services/health-care-costs-for-couples-retirement-rise

/---Excerpt------
The estimate assumes enrollment in Medicare health coverage but does not include the added expenses of nursing home or long-term care.

1. 2015 Fidelity analysis performed by its Benefits Consulting group. Estimate based on a hypothetical couple retiring in 2015, 65-years-old, with average life expectancies of 85 for a male and 87 for a female. Estimates are calculated for "average" retirees, but may be more or less depending on actual health status, area of residence, and longevity. The Fidelity Retiree Health Care Costs Estimate assumes individuals do not have employer-provided retiree health care coverage, but do qualify for the federal government's insurance program, Original Medicare. The calculation takes into account cost-sharing provisions (such as deductibles and coinsurance) associated with Medicare Part A and Part B (inpatient and outpatient medical insurance). It also considers Medicare Part D (prescription drug coverage) premiums and out-of-pocket costs, as well as certain services excluded by Original Medicare. The estimate does not include other health-related expenses, such as over-the-counter medications, most dental services and long-term care. Life expectancies based on research and analysis by Fidelity Investments Benefits Consulting group and data from the Society of Actuaries, 2014.

2. For purposes of this hypothetical analysis, a 4% to 5% annual rise in health care costs is assumed.
-----------------


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Response to DonViejo (Original post)

Wed May 24, 2017, 02:14 PM

11. This is a great example of issue advocacy and perseverance.

No one would deny that John Conyers is a Democrat. He has also been advocating single-payer for many years. Nevertheless, he supported Obamacare even though it wasn't single-payer. And he has continued to support single-payer since then.

See- you don't have to give up your principles by accepting something less than perfection. If the choice before you is a step closer to your goal or nothing, taking that step does not mean you have given up on your ultimate goal. Take what you can get and keep fighting.

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Response to MGKrebs (Reply #11)

Wed May 24, 2017, 03:51 PM

24. Thank you. You don't throw "universal health care" in the trash because it's not single payer. (nt)

 

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Response to DonViejo (Original post)

Wed May 24, 2017, 02:21 PM

12. Isn't This A Concession That Republicans Are Right About ACA?

Instead of defending or trying to expand ACA by adding a public option, Democrats are also abandoning it?

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Response to TomCADem (Reply #12)

Wed May 24, 2017, 02:25 PM

15. No, because this was the supposed compromise anyway.

So, the Dems could say, we need to go further, and while we're at it, let's go all the way.

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Response to DonViejo (Original post)

Wed May 24, 2017, 02:21 PM

13. This needs to happen! There's an MSNBC Commercial that shows Trump saying Australia's ...

... health care system is fantastic.

So, fucking the idiot even knows SPH is a great thing. Sanders needs to take this up as an issue while Trump is down. Now is the time to strike!!!

Trump might just ask for it from Republicans as a way to save his failing presidency! We should utilize this advantage to help the sick people of this country!

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Response to Fantastic Anarchist (Reply #13)

Wed May 24, 2017, 03:49 PM

22. Australia is very different from the US is some basic ways

 

Australia has less than 1/10th the population of the US.

80% of their population is in cities, making it much easier and more cost effective to deliver health care to the most people.

The US has 62% of our population in cities.

However, those in rural areas, especially the indigenous people, get poor quality health care.

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Response to ehrnst (Reply #22)

Wed May 24, 2017, 03:59 PM

27. A Single-Payer System is insurance, not health care.

So, the situation would be the same in terms of provider care, not insurance assistance.

So, in other words, in rural areas, people would have their health care paid for by the system. They would still need to go to the providers that already exist.

If the rural population needs more providers, we could provide that with the enormous cost savings we would have with SP.

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Response to Fantastic Anarchist (Reply #27)

Thu May 25, 2017, 08:38 AM

32. Single payer is the mechanism by which health care coverage is paid for.

 

I didn't dispute this - I was referring to the statement that Trump made concerning the Austrailian heath care system being better than ours, and pointed out some of the ways that it isn't. Rural access is one.

The fact that a large portion of their population is in cities does make health care more centralized and efficient, and therefore cheaper, which makes single payer more possible.

Is that clearer?

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Response to DonViejo (Original post)

Wed May 24, 2017, 02:42 PM

17. As Scarsdale points out, much of the problem with . .

 

the US health care system is due to the outrageous and corrupt
rip-offs by Big Pharma . .

to the tune of, believe it or not, around $ 400 BILLION per year.

Dems really need to stop taking money from Big Pharma

Here is who gets it now . .

https://www.opensecrets.org/industries/indus.php?ind=H04

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Response to DonViejo (Original post)

Wed May 24, 2017, 02:54 PM

18. where were those

 

voices back in 2010

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Response to burnbaby (Reply #18)

Fri May 26, 2017, 06:45 PM

70. We were right there,

Truman's plan for universal health care fails,???

LBJ's plan for universal health care shortened to what could be accomplished. Medicare

Nixon's plan for universal health care fails. HMOs, Kennedy opposed to it

Clinton's plan for universal health care fails. Doctors lobbies, pharmaceutical lobby, hospital lobby, against it.

Obama's plan – divide and conquer, more business for doctors, no limiting pharmaceutical prices (another day). Funding for unpaid care, eliminate pre-existing condition charges, eliminate lifetime limits, eliminate restrictions on coverage (only cover cheap procedures) – works despite Republican opposition. More work to be done.

Public option, Medicare option, thrown over the side to save the remainder because the Senate rules.

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Response to DonViejo (Original post)

Wed May 24, 2017, 03:34 PM

20. And now this is going to be used against as ammunition against any who

 

acknowledge that there are many ways that Europe has gotten universal health care coverage, the majority being multiple payers.

Sensible elected Democrats who dare to talk about the obstacles that are not being talked about will be vilified as shills, instead of knowing what health policy analysts do. Most developed countries use multi-payer mechanisms.

People should not equate "universal health care" with single payer, and that is what is happening. Single payer is one way, and it's expensive, and will be much more disruptive to implement.

Even Medicare isn't single payer, and is much, much less comprehensive than what "medicare for all" has been touted.

And, no, I don't work for "big pharma" or "big hospital" or "big doctor."

I'm saying that single payer as they describe will take at least 20 years to implement. Canada took longer than that. Canada only went federal with single payer after all the provinces did it independently of each other. With single payer failing in Vermont, and Coloradocare being soundly defeated last November, it's not looking good for the US to take the route they did.

We can't even keep the ACA for 10 years without it being chipped away at.

Here is a good overview of the subject from a premier self-funded, non-partisan health policy think tank:

http://khn.org/news/democrats-unite-but-what-happened-to-medicare-for-all/

(No, it is not connected with Kaiser Permanente. They are both named after the same person.)

I lived in England and loved the care I had there, and wondered for a very long time why we wouldn't do it here. I understand now, and think that it's dangerous to make "single payer or bust" party dogma. Universal health care, yes. But not limiting it to one, seldom-implemented method.

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Response to ehrnst (Reply #20)

Wed May 24, 2017, 04:05 PM

29. Well, we need to define what a multi-payer system is, then.

Single-payer would cover all costs of quality of life and life-saving medicine and therapies diagnosed and issued by doctors, not insurance companies. Anything that's more elective, can be provided for by a competitive other tier.

France has a single-payer system, that has more than one tier. It was last cited by the GHO as the best health care in the world. Single-payer is the basic medical care, and then the other tier is filled in by multiple competitors to insure for elective care.

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Response to Fantastic Anarchist (Reply #29)

Thu May 25, 2017, 08:45 AM

33. So France has a combination of payers - like the US. But they organize it differently.

 

Even Medicare isn't single payer, which shows just how hard it is to correct misconceptions.

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Response to ehrnst (Reply #33)

Thu May 25, 2017, 10:16 AM

39. Well, as I understand it:

Medicare has several "parts" to it. I think the basic concept is that it is a single-payer system with add-ons or parts that become separate tiers.

I don't want to continue with the semantics, just want to stress that a system, whatever we call it, that provides for the payment of medical care for everyone, is implemented. I've read HR 676, all 30 pages of it, and that bill calls for government sponsored payment system. I read it about six or seven years ago, so I can't recall the specifics.

The system could be implemented at the national level, and/or at the state level. We don't have to have an exact copy of France's or the UK's, or Canada's system, just use the blueprint provided by others, and tailor it for our needs.

In my view, the hard work has already been done for us. We would be wise to utilize this advantage now, while the President is weak and the Congress would be amenable to redeem itself with enactment of the bill. Hell, Trump, himself, unwittingly endorsed the system. Get him the bill and a crayon, and let him sign it so we can get to work.

People are dying that shouldn't have to die. Our descendents will look at us as barbaric if we don't.

Also, businesses should be attracted to this because of they are currently at a disadvantage, globally, because they have to foot part of the costs for their employees, while their competitors are free to profit or reinvest their revenues.

Edit: On my phone, so please excuse the errors

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Response to Fantastic Anarchist (Reply #39)

Thu May 25, 2017, 10:51 AM

40. The thing is, words matter. "Single payer" is not exchangable with "Universal Health Care"

 

Last edited Thu May 25, 2017, 11:26 AM - Edit history (2)

And I'm seeing that happen all over the place. Anyone who suggests that there are other options than "single payer" is called a corporate shill as fast as someone trying to talk to an antivaxxer about the safety of vaccines.

No, the hard work has not already been done. The huge infrastructure and of the health care system that will have to be demo'd an rebuilt has grown huge over the last 60 years, and will take more work that "simply expanding medicare to everyone" implies.

ColoradoCare was rejected soundly last November, and the only reason that it was possible for them (and Vermont) to even try to do that was that the ACA had a provision for states to experiment with their own systems.

The ACA is on the chopping block right now, along with much hope that states will independently create their own single payer systems independently of each other. It took Canada decades for all their provinces to do this, and only then did a federal mechanism come into being with the election of a very liberal administration. It was still being changed and tweaked legislatively in 1999.

No, our GOP Congress is not "amenable" to legislating any sort of federally supported health care coverage. They are trying to enact something quite the opposite.

Yes, people are dying that don't have to die. And yes, we look at our ancestors as barbaric for rejecting national health in the Truman administration when it could actually have been implemented before the massive infrastructure of our health care system was in place.

No, business will not "be attracted" to anything that will cost them money without an immediate return. See Vermont single payer, which exempted large businesses that had employees in different states from paying into the system. Those large businesses were NOT attracted to it.


Medicare requires multiple payers for the complete range of health care services - but those payers are administrated and regulated at the federal level. Medicare itself is a basic plan - not anything like what Green Mountain Care in Vermont, or what Sanders calls "Medicare for all." Those were/are far more expensive and cover more than actual Medicare, which is having some real issues right now with approvals for procedures and timely payment for services. Those issues need to be addressed, but as we have seen, this administration will not address the issue of fixing anything that is administered at the federal level - they want to cut, cut, cut.



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Response to ehrnst (Reply #40)

Thu May 25, 2017, 02:14 PM

42. I have no idea why we're arguing.

Have you read the bill?

Not even sure why we're arguing. Yes, words have meanings and words matter. That's why I said we're going to have to define what we're talking about.

When I say single-payer, I mean universal health care. Sometimes people say "single-payer" and sometimes they prepend it or append it with "universal." But I'm all for explicitly defining it as universal.

I read your post, and all I can really take away from it is fatalistic thinking.

I know the work will be hard. But blueprints are hard, too yet we have that advantage.

Regarding business, yes, they are against it now, but we need to frame the debate for them. Certainly posts such as yours will never win them over.

I'm looking at this as a chance. You seem to be looking at this as a chore.

I'm done.

All the best.

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Response to Fantastic Anarchist (Reply #42)

Fri May 26, 2017, 11:19 AM

43. I'm looking at this very realistically. It's become dogma.

 

"Single Payer is the only way to reform health care" is not very different than "If you get rid of Planned Parenthood, the largest abortion provider, then you will drastically reduce the number of abortions" is on on the right.

Dogma, which won't pan out into reality.

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Response to ehrnst (Reply #43)

Fri May 26, 2017, 12:37 PM

46. No you aren't. No it isn't.

You are using hooey and bunk in a concerted attempt to discredit what is almost certainly the most viable path for the US to achieve universal health care and medical industry cost control.

Hooey and bunk usually serve corrupt masters.

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Response to kristopher (Reply #46)

Fri May 26, 2017, 01:41 PM

48. You sound just like an anti-vaxxer or someone who wants to defund Planned Parenthood

 

Same anger and lashing out at hearing arguments that challenge your dogma.

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Response to ehrnst (Reply #48)

Fri May 26, 2017, 02:03 PM

50. You're the one engaging in name calling.

earnest: "You sound just like an anti-vaxxer or someone who wants to defund Planned Parenthood
Same anger and lashing out at hearing arguments that challenge your dogma."

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Response to kristopher (Reply #50)

Fri May 26, 2017, 04:02 PM

54. Un-Fucking-Believable.

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Response to Fantastic Anarchist (Reply #54)

Fri May 26, 2017, 04:09 PM

56. Absolutely-fucking-realistic-and-believable.

 

So much for "being done" I see.

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Response to kristopher (Reply #50)

Fri May 26, 2017, 04:11 PM

57. I said you sound just like an anti-vaxxer

 

And I explained why.



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Response to ehrnst (Reply #48)

Fri May 26, 2017, 04:01 PM

53. No. You are the one being dogmatic.

There's no getting through to you.

You think you are right and then resort to calling him an anti-vaxxer for having a different opinion? You think he's being dogmatic? Take a look in the mirror.

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Response to Fantastic Anarchist (Reply #53)

Fri May 26, 2017, 04:07 PM

55. No, I didn't say that because he has a different opinion

 

I said that because he is reacting in a very emotional way to being presented with evidence that challenges his beliefs, to the point of attacking me for something that someone else said in the post (from a very reliable and neutral source on health policy), without any data or even an attempt to address the data in the source.

Is that clearer?

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Response to kristopher (Reply #46)

Fri May 26, 2017, 03:57 PM

52. Bingo! Thank you!

I'm done with the other poster. He/she thinks he/she is being realistic. No. His/her thinking is why we're in a fight for the crumbs we have now. As far as Obamacare, it helps, but we are still defending a conservative position relative to what we could have. And then he/she wants too include semantics and other bullshit.

Hooey is right.

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Response to Fantastic Anarchist (Reply #52)

Fri May 26, 2017, 04:16 PM

58. You know, there is an "ignore" feature

 

if the information that I share upsets and outrages you so much.

It might be best for you.

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Response to ehrnst (Reply #58)

Fri May 26, 2017, 04:31 PM

60. I don't use ignore. That would be "dogmatic."

I'm confident enough in my positions to listen or read other posts.

So far you've made an ad hominem attack on another poster. Saying, "sounds like ..." is bullshit and weak. Have the courage of your conviction, at least!

You issue a non sequitur with the whole single payer is not universal argument.

You issue a red herring with your a anti-vaxxer comparison.

Refuse to answer my question twice with regard whether or not you've even read the bill.

You issue a straw man with the whole "outrage" bullshit. I never once said I'm outraged. You're not important enough for me to be outraged. That's not an insult, it just is. If you look through the thread, I posted that I don't care what we call it, we just need to get it done. You seem to still be stuck in a naming convention that no one else fucking cares about. I think you read something once about single-payer may not be universal, and now you want to show off this new found knowledge, when no one even solicited that info. It doesn't refute or enhance our argument. It's information-neutral.

Again, I look at SPH as a chance, and am flexible with however we want to implement it or name it.

Your posturing seems to be stuck in semantics. You seem to look at this chance ...as a chore.

I promised before, and lied, that I was done. This time, I am. Have the last word. I hope for your sake you don't. I would be embarrassed. People can read, you know?

All the best ..

On phone: please excuse errors

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Response to Fantastic Anarchist (Reply #60)

Fri May 26, 2017, 04:42 PM

62. I call them as I see them.

 

Yes, the poster "sounded like."

No, the anti-vaxxer comparison is not a red herring.

Yes, I have read the bill: https://www.congress.gov/bill/115th-congress/house-bill/676?r=6

I think that the language in this thread such as "Un-fucking-believeable" merits the descriptor "outrage."

"Posturing" as you call it, does request using correct terminology as per health policy analysts, (once again -just as calling abortion "baby killing" is not only incorrect, it has legal implications).

And I seriously doubt you are "done."

All the best.





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Response to ehrnst (Reply #40)

Fri May 26, 2017, 12:44 PM

47. "Single payer" *IS* exchangable with "Universal Health Care"

It depends on the nature of the conversation and the intended message of the person constructing the sentences. Just because you don't what to have the two concepts used interchangeably doesn't mean you get to have your way.

That's the difference between Oxford and Webster dictionaries - Oxford insists in trying to tell people how they must use language while Webster's insists on an approach that tracks how people DO use language.

Since language is a rapidly evolving facet of culture that is driven by input from all members of a culture, I subscribe to the point of view forming the basis for Webster's editorial decisions.

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Response to kristopher (Reply #47)

Fri May 26, 2017, 04:17 PM

59. In the way that "dog" is exchangeable with "mammal"

 

Is that clearer?

And you can call a cat a dog all you want, but it won't fly with a veterinarian. And when you talk about health policy, then you use the terminology of health policy analysis.

When anti-choicers call a fetus a child or an infant or abortion murder - they aren't correct medically or legally when talking about medical and legal issues, even if many of them agree about it. That choice of words is deliberate, and has political implications.

They also react the way you do when that is pointed out. I think a look in the mirror is in order for you.

Single Payer is one method of universal health care, and most developed countries have multiple payer systems to achieve universal health care coverage.

If you don't believe me, google it.



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Response to ehrnst (Reply #59)

Fri May 26, 2017, 05:17 PM

67. And you can run shouting that around until the cows come home...

...and at the end of the day people are going to continue using them interchangeably. That's because everyone intuitively gets that there's a shift in bargaining power buried in the very idea of 'single payer' or 'Medicare for All'.

Common discussion needs a shorthand way to express that realignment in bargaining power without having a drawn out round of definitions being thrust in their face. And they are going to create that shorthand (no matter what you do) because it facilitates the broader and more fundamental discussion on what values do we hold to be most important.

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Response to kristopher (Reply #67)

Fri May 26, 2017, 05:25 PM

68. Just like some people are going to call pregnancy termination "murdering babies"

 

And them insisting that "abortion" and "baby killing" are interchangeable isn't any more accurate, and doesn't "facilitate a broader and more fundamental discussion on what values we hold to be most important."

Most of the developed world has multi-payer systems. Those are not "single payer" nor are they synonymous with "medicare for all"

In fact, "Medicare for all" as described isn't synonymous with "Medicare."

And that's an important, factual distinction.

And I'm not the one doing the "shouting." Let's save that definition for someone responding with "That's a bunch of Hooey."

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Response to DonViejo (Original post)

Wed May 24, 2017, 05:40 PM

31. When can we expect the CBO numbers?

Last edited Wed May 24, 2017, 09:03 PM - Edit history (1)

Can't wait until the Repugs explode when the CBO numbers show how good single payer would score.

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Response to MichMan (Reply #31)

Thu May 25, 2017, 09:15 AM

37. The CBO crunches the numbers on legislation that has been approved by

 

Congressional committees other than the House and Senate Appropriations Committees.

So far none on Single Payer has gotten that far.


Bernie has submitted a paper with his plan, and various people have crunched numbers on it, but it must be in a bill, and that bill must be detailed enough for the CBO to make projections about the costs and the savings, and the timeline of those costs and savings.



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Response to DonViejo (Original post)

Fri May 26, 2017, 08:45 PM

71. Physicians for a National Health Program support single-payer national health insurance.

Who is PNHP
Physicians for a National Health Program is a non-profit research and education organization of 20,000 physicians, medical students and health professionals who support single-payer national health insurance.





http://www.pnhp.org/about/about-pnhp

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Response to kristopher (Reply #71)

Sat May 27, 2017, 07:12 PM

74. I believe that they are very consciencious. When you have 20,000 health policy analysts

 

who are saying the same, that will mean something very different.

Physicians are to Health policy analysts as Meteorologists are to climate change scientists.

This does not diminish physicians or meteorologists. It's just that they are not trained in those other sciences.

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Response to DonViejo (Original post)

Sat May 27, 2017, 07:34 PM

76. What is single payer?

What is single payer?

Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private. Under a single-payer system, all Americans would be covered for all medically necessary services, including: doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs. Patients would regain free choice of doctor and hospital, and doctors would regain autonomy over patient care.

http://www.pnhp.org/facts/single-payer-faq


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