My idea of health insurance:

[kentuck]

Everybody is on Medicare. Everybody pays the premium of $103 per month if they are working? Nothing goes to the insurance companies.

If someone loses their job, there could be a formula worked out where they only pay 50% of the premium (about 12.50 per week) and the other 50% would be subsidized. Or if they had no income, they would be eligible for Medicaid.

To me, this would be the ideal healthcare system. And, although I don't know the exact statistics, I would estimate that young people go to the doctor almost as much as old people - just for different reasons. They are more likely to be in auto accidents, or have injuries skiing or playing sports, or other reasons. Young people do not tend to take real good care of themselves because they think they will live forever.

But, now we are hearing about people's premiums going up humongous amounts, because of their coverage with the insurance companies. That would not happen with a single-payer.

[gopiscrap]

1. My idea of health insurance: fuck health insurance

and go to universal single payer health care system no one and I mean NO ONE or company should ever make a profit from health care

[Bunnahabhain]

16. If no company should ever make a profit from healthcare

why would they produce healthcare supplies? Why would a company do R&D on medical devices?

[Fawke Em]

21. The government funds most R & D, now, not private industry.

So it wouldn't make that much of a difference.

[Bunnahabhain]

25. Remember this post

Robert Reich has spoken on this. You know, noted lefty, former Clinton Secretary of Labor?

[gopiscrap]

56. Nationalize it, like they do in Europe

[feathateathn]

24. So, doctors, nurses etc are going to be all volunteers??

How would that work, exactly?

[OwnedByCats]

57. In Britain

Doctors and nurses don't work for free you know. They get paid their salaries by the NHS - run by the government which makes no profit, taken from taxpayer money, useable for all. Universal care is not free, it comes out of your taxes but it's a million times better than the sorry system we have here. The only outgoing cost other than taxes is an affordable copay for scripts, one cost for any drug, at any quantity.

[dkf]

27. +1000. Geez don't people realize Medicare OOP is still expensive and you need a medigap policy too?

Moreover that premium only covers 25% of the cost so if you put everyone on Medicare you need to raise taxes to pay for it anyway.

[Worried senior]

42. We have Medicare,

love it but it costs plenty for the supplement which goes up every year and the Part D is getting more and more expensive. They play with the formularies for the medications so you pay higher co-pays and deductibles. Anyone that thinks it's a free ride is definitely wrong.

I am very happy to have it but every year it gets harder to meet our obligations, if we do get a cost of living increase everything else goes up much higher than what little bit we get.

[Bunnahabhain]

2. So Bill Gates pays $103 and the dishwasher at TGI Fridya's pays $103?

Sounds like a plan to me.

Give me a good Bismark system and stop with the "single payer hurr durr!"

[kentuck]

5. Your premium is your tax.

Medicare is a single payer. But what you pay for Medicare should have no bearing on what you pay on your total income. Twenty five dollars a week would be about 7% of a minimum wage earner. But they could qualify for a subsidy and end up only paying about 3 1/2 percent for health coverage? Sounds fair to me? Certainly better than those policies that are reportedly going up 600%..

[Bunnahabhain]

6. I think single payer is bad

Bismark system.

And I still think a system where Bill Gates pays the same premium as a dish washer is less than rational.

[kentuck]

7. Do you think Bill Gates should get the same quality of care as the dishwasher?

If so, why should they be charged differently? This has nothing to do with a progressive income tax that should be paid by amount of financial worth.

[Bunnahabhain]

10. One has nothing to do with the other

I do not believe in a single payer system (Bismark please) and I think it is stupid for a society to expect a dishwasher to contribute to the healthcare system at the same raw dollars as Bill Gates.

[kentuck]

14. We disagree.

I would not support a progressive tax for health insurance.

[DireStrike]

38. Is there anything else you don't support progressive taxes for?

And why is health care different than any other service?

[OwnedByCats]

58. Lived in Britain for 10 years

They have what you're against and it's fantastic compared to our system. At least people need not worry about how to pay for their life saving treatment, never go bankrupt over it either. It's not "free" and it shouldn't be - but it's made affordable for all, can be used by all. You can go "private" and go the pay out of your pocket route, or get an insurance policy however I found the care paid for with my taxes was more than satisfactory. I got much better care there than I do here, but here I get to pay more than I can comfortably afford.

[roamer65]

3. Give me Canadian-style single payor.

Everyone pays for the system through taxes and you just have healthcare from cradle to grave. No appreciable insurance premiums.

[Bunnahabhain]

4. That's not really true

Look at Ontario, for instance. It has a direct levy for health care they deduct from your taxes as of 2004. So OHIP is funded, in part, not by some nebulous transfer/budget mechanism but rather from a direct tax, just like an insurance premium, right off your paycheque.

http://www.fin.gov.on.ca/en/tax/healthpremium/


Additionally people do pay insurance premiums for things like employer based drug coverage. Drugs are not covered directly under the system. Ditto eye insurance.

It's almost like I'm Canadian or something.

[dkf]

28. Sanity!!! Thank you.

[former9thward]

8. Young people do not go to the doctor the same as old people.

When they do go it may be for different reasons but it is not remotely the same percentage. Go to doctor's office and see who you see. The average age is close to SS age.

[enlightenment]

32. Do you have proof for that?

If you know percentages and things, I'm thinking you have a link to a study. Please share.

[former9thward]

54. I have the same proof the OP has when it said young people go to the dr the same as old.

None, and I don't care to research it. I just have my eyes and common sense. If those aren't good enough, oh well....

[Lex]

9. Kill health insurance companies.

They are just in the way and offer nothing of real value.

[Bunnahabhain]

11. That is not true at all

It was HMOs that forced the "small area studies" and "best practices" back in the 70s and 80s. They have put real value into saving millions of lives.

I hate when people want to toss the baby out with the bath water. The current US system is fucked beyond belief but the truth is the truth: health insurance companies have improved healthcare by demanding improved practices.

[Lex]

13. We need single-payer and for the health insurance companies

to go away. Medical professionals save lives, not insurance companies.

[Bunnahabhain]

15. You are just plain wrong

The data is there for you to find. Insurance companies forced physicians and hospitals into thinking about quality, best practices, etc. It saved millions of lives and continues to do so. They are not evil incarnate no matter what some folks want to say.

[CANDO]

17. Insurance companies do ONE THING

They create risk pools from which they extract profits. That's it. They do not deliver healthcare. They do not monitor quality of care. They manage risk pools for profit. Medicare for All would be a risk pool of ALL OF US, not multiple risk pools for profits. I do say keep some portions of the industry for profit, such as medical devices, etc.

[Bunnahabhain]

18. They do manage for profit

Now, let's use our brains (I know, not overly encouraged). How best does one manage healthcare to obtain profit? Let's further granulate this question: how does one manage hospital stays to obtain profit? By helping to discern and promulgate the best way to make people well and not extend hospital stays.

I'm not making this shit up; it's all there for people to read on their own. I've recently been involved in some studies using wireless iPads for high utilizers in the ED by people with COPD and CHF. Amazing results.

[CANDO]

19. I and we are not saying they don't do it well.

They are enormously profitable. I and we are saying they are actually a detriment to our nation's overall health by taking money from the system that should be going to making people well. They are unnecessary.

[Bunnahabhain]

22. Saying they are unnecessary

is different from saying they have never done anything of value. Also, if they are unnecessary, why do so many countries with universal healthcare have them? German, Japan, France, just to name a few. Do you think all these countries have bad healthcare?

[DireStrike]

39. I think it's just easier politically to get a system like that set up than a single-payer one

Though I am open to a Bismarkian model if the claims of its supporters (that the multiple risk pools somehow result in better rates than one large pool with more collective bargaining power) are true. If.

Where were you guys when ACA was being discussed? I just heard about the Bismarkian system for the first time a few days ago (both the name and the idea that it is somehow more efficient than single payer.)

[Bunnahabhain]

48. No one wanted to hear anything other than their own narrative

I've talked until I'm blue in the face. No one really wants a rational discussion and/or to educate themselves on the options. People are stunned to find out France, Japan, and Germany are not single payers.

Here is a great link on the OECD: http://www.oecd.org/els/health-systems/OECD-Health-Data-2013-Frequently-Requested-Data.xls

You'll see Canada, single payer I grew up under and that so many Yanks think is Nirvana, is outdone by Bismark systems in many metrics.

Dire, thanks for at least listening. It's the one person in a thousand that is at least willing to think about this that keeps me going.

[DireStrike]

52. Well I still expect to come up with some objection to the system

But it won't be one that denies facts at least.

Thanks for your patience and information.

[OwnedByCats]

59. Heard the horror stories

about Canada and as I've never lived there, I cannot comment. However Britain's system is really good. You can pay outright or buy an insurance policy and go to private clinics and hospitals. However, most people in Britain use the National Health Service paid for with taxes and they only need to worry about their small copays for scripts.

The United States is the only developed country without some type of universal care available to everybody. If things carry on the way they are, with costs rising all the time, only the Bill Gates of this country will be able to afford their health care.

[CANDO]

55. I don't know the intricate details of other national plans.

I just know leaving the middlemen as skimmers here is not helpful. Left in place, heavily regulated with profits limited to a certain %, then I may not have a problem with it. But letting those dollars go to middlemen in the form of profits when we can have a risk pool of all Americans and have an overhead of maybe 3% in running it seems a no brainer to me.

[eridani]

60. The governments of those countries dictate what cost and coverage are n/t

[Lex]

20. No. They make profit

by refusing to pay for sick people's health care, and taking the money from healthy people while they're healthy.

[Bunnahabhain]

23. Then why are hospitals full of sick people getting things done insurance is paying for?

Or do we just living in different realities?

I am not saying insurance companies are "good" but I am saying ya'll are full of it with what you're saying about them. Posting stupid things does not build credibility for informing rational change.

[Lex]

26. Look at countries with single-payer. People get MORE health care for less money paid.

Why? Because insurance companies.

[Bunnahabhain]

29. Not really.

Canada does not get more healthcare than France or Germany. In fact, they get less in many metrics.

[Bunnahabhain]

30. Go to page 117 of this link

http://www.scopemed.org/fulltextpdf.php?mno=20023

Tell me Germany, that has a health system that has insurance companies, does not have more healthcare resources than Canada. More docs per person, more hospital beds per person, more imaging equipment...

[Lex]

31. Germany's insurance companies are tightly monitored and regulated by their Government.

Nothing like the crooks here in the US have gotten away with for so long.

[Bunnahabhain]

47. But they're insurance companies

Care to modify your statement now?

[enlightenment]

33. You are saying many things, but

offering little by way of proof.

Please provide some of that, since you have moved from "I don't like single payer systems" to "you are just plain wrong."

The first is an opinion - the second an assertion. Assertions require proof.

[Bunnahabhain]

44. I provided proof in a link above.

Please enjoy reading it.

[enlightenment]

49. Sorry, but you didn't prove your point.

Germany does not use largely unregulated, for-profit insurance companies as intermediaries. Nor does any other country that uses insurance companies as intermediaries. You're comparing apples and oranges.

Find some apples.

[Bunnahabhain]

50. Straw man

I never made that proposition, did I?

Btw, insurance companies in the US are regulated.

[enlightenment]

51. Reading comprehension.

Try it.

[Bunnahabhain]

53. Yes, I have obviously demonstrated I lack reading comprehension in this thread.

You have yourself an enlightened day now.

[SoCalDem]

41. You are certainly a persistent one, aren't you?

Look:

The facts are what they are..

The US has a SHITTY delivery system for health care UNLESS you are RICH


Talk to ANYONE anywhere that HAS a national/universal/single-payer (whatever you want to call it) and ask them to swap with what WE have... They will laugh in your face.


We have a crazy quilt that's ragged at all the edges..

Conservative obstructionists in congress have been ruining lives for decades now when it comes to delivering the rewards of citizenship anyone deserves from their country... healthcare (not "insurance&quot should be a birthright.

When conservatives want a war or a war-toy, they move heaven and earth to find ways to pay for it...so it should be for healthcare too. If rich have to subsidize poor, that's fair too.. if they don't like it, they can move

[Bunnahabhain]

43. What does this have to do with this conversation?

Oh yeah. Nothing.

I am persistent because I have the facts and information on my side. Hurr durr is harder to maintain.

Also, I'm not rich and I assure you my healthcare in the US is superior to the healthcare I had back in Canada under OHIP. I know you will not want to believe this but it's true. Cue, "ONLY BECAUSE YOU HAVE A JOB!!" (even though that does not change the truth value of what I just said).

Edit: oh yeah, and as far as rich subsidizing poor? You obviously did not notice me telling the OP I thought the dishwasher paying the same premium as Bill Gates was stupid.

[SoCalDem]

45. ////

[Bunnahabhain]

46. Stunning reply

But fully expected.

Rage on, brother! I'll just continue trying to educate Yanks that there is more choices than the current US system or single payer, choices any rational analysis will demonstrate to be superior to both.

[BluegrassStateBlues]

12. There are people I know that will pay $13 under the ACA that have never had health insurance.

That's good enough for me.

[Puzzledtraveller]

34. I just selected my plan on our open enrollment.

As usual my premium was increased but what is worse is the actual plan covers less. Higher deductible, out of pocket, prescription overall. I have been with state government for 5 years. I will be getting married in April and we are expecting a child. I won't be able to afford it.

[libdem4life]

35. Single Payer. We do have a model ... Kaiser Permanente.

All health professionals are paid reasonable salaries for their education and specialty level. They have their own hospitals and even provide some mental health benefits...limited, but are especially good with drug addiction services.

In a Kaiser facility, they have Pediatric Units...lots of little kids and parents. They have Sports Medicine...lots of teens and young adults with casts and such. GP...Geriatrics...Specialties...same story.

Where they really save, I believe, is in preventative practices and classes, reasonable holistic health care, 24/7 telephone Nurse Practitioner Services, and not providing unlimited heroic, 6 figure operations for seniors.

Why should we reinvent the wheel. This system has been around since 1948. It's a common sense mix of profit and non-profit.

"The two types of organizations which make up each regional entity are:

Kaiser Foundation Health Plans (KFHP) work with employers, employees, and individual members to offer prepaid health plans and insurance. The health plans are not-for-profit and provide infrastructure for and invest in Kaiser Foundation Hospitals and provide a tax-exempt shelter for the for-profit medical groups.
Permanente Medical Groups are physician-owned organizations, which provide and arrange for medical care for Kaiser Foundation Health Plan members in each respective region. The medical groups are for-profit partnerships or professional corporations and receive nearly all of their funding from Kaiser Foundation Health Plans. The first medical group, The Permanente Medical Group, formed in 1948 in Northern California

http://en.wikipedia.org/wiki/Kaiser_Permanente

[FarCenter]

36. The Medicare payment is for Part B only. Doesn't cover Part A or Part D.

Part A and some of Part B is covered by Medicare taxes on incomes of people who are still working. Part D is covered by separate premiums and by general fund tax revenues.

Federal, state, and local government spending is currently at around 40%. Spending on healthcare is at about 18% of GDP and rising.

Roughly half of healthcare is already accounted for in government spending for Medicare and Medicaid. But adding in the other half of healthcare to the government budget would put government spending at about 50% of GDP.

[Sgent]

37. You wouldn't want Medicare

unless you have a supplement from a private insurer.

Yes Medicare only has a ~$200 part B deductible, but it has a 2,700 hospital admission deductible (per admission), + 20% -- with no maximum.

BTW the private insurers make a lot of money by administering Medicare.

[DireStrike]

40. What's wrong with progressive taxation?