NoShit...it's that Simple.

[pbmus]

Last edited Mon Mar 27, 2017, 08:45 PM - Edit history (3)

[URL=.html][IMG][/IMG][/URL]

It really is NOT complicated... The Big Con and the oligarchs are gaslighting healthcare.

I am not intimating that brain surgery is simple or any other medical procedure for that matter, but the administration of how we receive those services has been simplified in virtually every other developed country on earth...WHY NOT IN THE UNITED STATES? .WHY NOT IN THE UNITED STATES? .WHY NOT IN THE UNITED STATES? .WHY NOT IN THE UNITED STATES? .WHY NOT IN THE UNITED STATES? .WHY NOT IN THE UNITED STATES? .WHY NOT IN THE UNITED STATES?

[Phoenix61]

1. Yes! That's it exactly!

We need to push this until they are so sick of hearing it they agree to it just to shut us up.

[Squinch]

2. Kick! Perfect!

[Break time]

3. Also

They already have the basic infrastructure in place

[bronxiteforever]

4. K & R

[Eliot Rosewater]

5. But Walmart greeters and mechanics and whatever who vote Republican are looking at

that and saying "where are the obscene profits for corp executives who do nothing but prevent me from getting healthcare?"

what about them?

[Hortensis]

140. Minus the gratuitous insults of nice greeters, you've hit

on another "it's that simple" factor: Anything a democracy does needs to be approved by a majority of the voters. To put it mildly, a majority was not ready to approve a single-payer system.

Very on point, most of us cheered as LGBTxyz marriages were made legal in many states by JUDICIAL FIAT---only a few by majority vote, but the subsequent backlash against that was a big reason why Republicans now control both the executive and judicial branches. Even though a modest majority of conservatives, asked nicely, were in favor of legalizing "gay marriage."

Of course expanding Medicare IS the obvious way to give trumpsters what Rump promised them: A new version of healthcare reform that ditches the Obamacare name and gives them more for paying less. Go sell it to Rump. He'll sell it to them. Then the Koch/Mercer types will arrange to have him removed from office. It's not time.

[pbmus]

156. When do you think the time will be...?

When we are paying $750.00 for a pill that costs less than .10 cents to make....we are there...

[Hortensis]

161. Apparently that's not enough.

If it weren't for Citizens United and other similar corruptions, my guess is the time might have been 9 years ago.

[Eliot Rosewater]

157. Not an insult at all, meant to show how hard working people vote against their-selves.

I could list auto mechanics, daycare workers, secretaries, etc., the ones who vote against their-selves are the reason we are here.

Meant to point out hard working people have nothing in common with major league criminals like Trump.

[Hortensis]

162. Sorry, I know. Should have put a smile after it. :)

It was a joke.

[mahina]

6. The brutal health care system we live under now is institutionalized violence.

[pbmus]

155. Unfortunately, Correct...it doesn't have to be that way..

[ehrnst]

182. And anyone that dares to point out the problems with single payer

MUST BE CORRECTED!!!

[tenorly]

7. Perfect - except they forgot the gold overflowing from the trash can at right.

And the cigar-chomping, orgy-bound executive skulking away with it.

[warmfeet]

8. Single payer,

let us all make it so.

[CitizenZero]

9. Private Sector

I have long thought that business people in the Private Sector might prefer a Single Payer System. It takes the provision of health care to their employees out of the business' hands and into the government's. I know that if I ran a business selling widgets, I want to focus on widgets, not providing Health Insurance as a benefit to my employees.

With Single Payer, businesses no longer have to worry about providing Health Benefits to their employees. They can focus on their core business instead. It is probably cheaper for them to do so, since government is handling simplified administration of one type of plan. So, I have always thought that there should be more support for Single Payer from the business community.

[PoliticAverse]

137. Many would but many businesses use health insurance to make it difficult....

for employees to quit. "I can't quit I'd lose my health insurance".

I was really hoping the ACA would do more to separate health insurance from a particular employer.

[CitizenZero]

163. Good Point

Thanks for the input. Maybe when the Dems get back in power we can amend ACA to separate health insurance from particular employers, as you say.

[BadgerMom]

10. K & R

[MontanaMama]

11. Hallelujah!

As someone who worked for 21 years in the health care field and didn't have employer based insurance this makes perfect sense. As someone who now owns a business that employs 7 people this makes perfect sense. If everyone has what they need then EVERYONE has what they need!

I've lost countless nights' sleep worrying about someone in my family being sick or getting sick and I know I'm not alone. Enough. Let's do this and move on. Lord knows there's got to be some other evil venture the rethugs can focus on. Dems need to begin this conversation. Folks are ready to hear it - even dumpsters could be persuaded.

Where are large corporate entities on supporting this so that they can get out of the insurance business?

[ThoughtCriminal]

12. The chart "simplifies" the current healthcare system

In reality, it cannot be diagrammed in two dimensions... and probably not three or four.

[pbmus]

13. Anyone who wants to make it complicated is

trying to include capitalism in the formula...

healthcare should not be about making money.

[jmowreader]

14. I'm going to throw a fairly large wrench in the works here

Unless you're planning to do one of two things - socialize the entire US healthcare apparatus or dictate to the providers they can't charge more than the breakeven point - healthcare will always be about making money. That's what private-sector businesses DO, pb; since we are still nominally a capitalist country, making money is not a problem.

The problem is obscene profit, and not profit per se. (Insert picture of Martin Shkreli being dragged away in irons here...) 99-percent pyrimethamine powder costs $60 per kilogram. That's enough to make 40,000 Daraprim tablets...or in money terms, the drug in one of Shkreli's $750 pills costs 15/100ths of a cent. According to the package insert, the rest of the pill is corn and potato starch ($500 per metric ton, 20 metric tons minimum order), lactose ($3 per kilo, 20 kilos minimum order) and magnesium stearate ($2 per kilo, 1000 kilos minimum order). Even if you pay the nice lady who runs the pill forming machine $25 per hour, you will still make a very nice profit at 10¢ per tablet, and you'll make out like a bandit at 25¢ per tablet.

So...the big question isn't how we get money completely out of medicine, but on how much money is enough and how do we limit people to that amount?

[pbmus]

15. Cmon now, We are presently limiting people (doctors and hospitals)

It is called Medicare and Medicaid...

I would add, we can adjust those limits thru legislation, which has been the oligarchs nightmare...

[ehrnst]

47. LBJ had to lie about what Medicaid and Medicare would actually cost in order to get it passed.

He knew it would not if the real estimate was known. You can't do that now, because we have the CBO.

There are some very real problems in Medicaid and Medicare, due to the politicization of health care, and to expand that to the entire population could result in gridlock.

You seem to throw the term "oligarchs" around as though that is the only complication in health care coverage as it is, and is the bogeyman behind everyone that doesn't agree with your "It's just that simple!" declaration.

I guess it's easier than doing the very boring work of health policy analysis.

[pbmus]

48. Sorry about your negative proclivity...it's called mental gridlock...

[ehrnst]

51. Facts bother you?

You aren't going to last long in any sort of effective movement with that negative reaction to not having your biases confirmed.

That's the definition of mental gridlock.... banging your head against the wall when presented with evidence that doesn't support your dogma.


Democrats Could Learn From LBJ’s Medicare Push (National Public Radio/Morning Edition, August 26, 2009, Renee Montagne)

[NPR-Montagne]: There are tapes of Johnson showing a different side of how he worked [Medicare’s passage].

[James Morone, co-author of The Heart of Power: Health and Politics in the Oval Office]: Johnson maneuvered every step of the way getting this bill through Congress, and one of the things he did "” and this is a little dicey in today’s climate "” was suppress the costs. So this young kid gets elected from Massachusetts, Ted Kennedy, in 1962, and Johnson is explaining to him [over the phone] how you get a health bill through. And what he tells him is don’t let them get the costs projected too far out because it will scare other people:

“A health program yesterday runs $300 million, but the fools had to go to projecting it down the road five or six years, and when you project it the first year, it runs $900 million. Now I don’t know whether I would approve $900 million second year or not. I might approve 450 or 500. But the first thing Dick Russell comes running in saying, ‘My God, you’ve got a billion-dollar program for next year on health, therefore I’m against any of it now.’ Do you follow me?”

[JM]: We believe, after looking at the evidence, my co-author [David Blumenthal] and I, that if the true cost of Medicare had been known "” if Johnson hadn’t basically hidden them "” the program would never have passed. America’s second-most beloved program would never have happened, if we had had genuine cost estimates…"


And just for the record, Planned Parenthood doesn't sell baby parts, and prevents more abortions than all the right to lifers put together. This elicits the same reaction you gave to me, among rightwingers who have hitched their star to closing Planned Parenthood. Dogma is dogma, whether it's on the left or right, and will sink us in the effort to effect actual universal health care coverage.

I know you don't want to hear about how Canada got their national single payer.....

[pbmus]

52. You have been sold a bill of goods, that my grandfather would say

are laced with bad intentions. The cost of any program can be justified or not....Look at Defense...which I am sure you block vote yes on every time it comes up...

[ehrnst]

57. I get it - you think I'm one of them evil politicians, because no one could possibly disagree

with your dogma, and have a decent bone in their body.

To be fair, I clearly have a much, much broader understanding of health policy than you do. You seem to cling to Single Payer as if it is the Nicene Creed of being progressive. Just as clinging to the idea that Planned Parenthood is selling babies is de rigeur for conservatives.

My knowledge comes honestly, I assure you, and it did not involve politics or any industry.

For instance - here is an alternate method of cost controls that is being tried out in MD:

"In the 1970s, a number of northeastern and mid-Atlantic states set hospital rates for private payers and Medicaid, and some received waivers to include Medicare in their systems. When the shift away from regulation took hold in the 1980s and Medicare inpatient prospective payment was thought by many to be adequate to control hospital costs, each of the systems was abandoned except for Maryland, which continues to this day.

I believe that Maryland’s staying power is a direct result of its structure as an independent regulatory agency. The Maryland Health Services Cost Review Commission resembles what some are discussing today as the “Federal Reserve Board” model of governance for health care. The governor appoints volunteer commissioners to long terms, and commission decisions are not reviewable by the legislature or executive branches."

Mind you - Health Affairs is not a partisan organization, nor is Rienhardt in the health care industry.

https://www.washingtonpost.com/news/wonk/wp/2014/01/16/is-the-u-s-too-corrupt-for-single-payer-health-care/?utm_term=.357a1a5988ce

[pbmus]

59. Can you explain the reasons why the United States of America is different than ...

[URL=.html][IMG][/IMG][/URL]

[ehrnst]

68. Where to begin....

First of all, not all of those are single payer. Look it up if you don't believe me. Universal coverage is the umbrella term for everyone having healthcare in some form or another. Our own Medicare isn't actually single payer, if you use the correct definition.

Since you didn't give the source of this chart, I'm not sure how accurate the dates are - and you know how I am about facts. You would do well to be a bit more concerned about the accuracy of your information....

But assuming that these are all correct, and the definition of universal health care is correct.... As I said, it would have been much simpler to have done this in the Truman administration, before our country built a massive health care infrastructure on private coverage. Starting from scratch is easier, and after WW2, many of these countries were rebuilding not only their infrastructure, but their economy from the ground up. Understand?

The U.S. is a much more diverse country racially and socially than many of those countries. Some have a state religion, some are overwhelmingly one religion. Their idea of "tribe" is much larger than ours in many of those countries. We veiw our "tribe" of financial responsibility as involving our nuclear family, and perhaps grandparents. But certainly not the neighbors. We are a country of individualists. Yes, there are tribes within church congregations who pitch in - but mostly, in the U.S. people want to specifically choose who they support outside their family.

And again....Canada didn't have federal health care until all the provinces had established their own independently of each other, starting in the '40s. Then they had a very liberal federal administration in 1966 that codified funding at the federal level. It was still being tweaked legislatively in 1999, so it was far from done in 1966.

Anything else I can clear up?

[pbmus]

70. You have pointed to the fact that the USA is different...we agree

It is different than every other country on earth...

[URL=.html][IMG][/IMG][/URL]

[ehrnst]

77. Did you read the post? You asked the question, and I answered.

I guess you didn't.

[qwlauren35]

167. Yes, I do.

How did Canada get national single payer?

BTW: Johnson was an absolute master at pushing through unpopular legislation. All of the Civil Rights legislation had to get past the staunch opposition of Southern congresscritters and Senators. But he did it. Thank goodness.

[CitizenZero]

19. Interesting Post

I was wondering where you got the above information about the cost of ingredients in meds. Are you in the Pharma Industry, or a Pharmacist? I find this stuff fascinating, and I am just curious about the source of your information.

[jmowreader]

23. Alibaba is your friend

I did this.

First, I went to drugs.com and found Daraprim, and this is the page: https://www.drugs.com/pro/daraprim.html

Then I went to alibaba.com and looked up the prices of its four ingredients.

[CitizenZero]

31. Thanks

Thanks for the info.

[radical noodle]

105. It's not only big pharma... it's doctors

and hospitals and all the other people & places that provide the services for the income. Those issues must be settled before single payer can work. There will have to be a decision about that 95-year-old lady with terminal cancer who wants chemo. There has to be a decision about the child with a terminal disease and how much treatment is reasonable. Is that up to doctors or the family or the government? What about those people who are hypochondriacs and constantly believe they have some disease? (I knew one woman who had a total hysterectomy who firmly believed she was pregnant.)

And what is reasonable? Is it reasonable to allow drug companies a deduction for advertising their products on TV when that adds so much to the cost?

[ehrnst]

45. Or perhaps it's complicated because it's been entrenched in the

health care infrastructure for nearly 70 years.

The time that it would have been simple was during the Truman administration.

Now, not so much.

[pbmus]

46. Medicaid and Medicare and the VA...and of course Tricare and ChampVA and...

And probably the one you are covered by, the congressional medical pool...

[ehrnst]

53. Actually no. Nice deflection, tho.

You are going to really get a headache banging against the wall like that.

Do you try to demonize everyone who refutes your claims with facts?

Public support is also very dependent on labeling:

http://kff.org/health-reform/perspective/medicare-for-all-vs-single-payer-the-impact-of-labels/

[pbmus]

56. The only label that counts today is, HOW MUCH....for the 99ers

The 1%ers and there handlers and enablers do not really give two shits...

[ehrnst]

61. I see you replied without actually reading the post.

When the public is presented with a question in a poll, how they respond is very influenced how one words a question.

Still with me?

This has to do with how much they do and don't know about health care policy.

For instance, "Medicare for all" is not what Bernie described in his plan at all, but since so many are not familiar with the limitations of Medicare until they are on it, they couldn't tell the difference.

Still with me?

Medicare doesn't cover dental, hearing, vision or prescriptions. You must purchase supplemental privately run plans for those.

The average Medicare recipient pays 14% of their income on medical care.

Now - one reason that Vermont single payer tanked is that it was comparable to a gold or platinum plated plan. It was going to require a 160% raise in taxes to sustain it. The citizens declined. There were other administrative errors, but you really only get one chance to do this with people's health care, and Vermont isn't going to be doing that again.

Canada didn't get national single payer until all the provinces developed their own independently. Vermont canceled its experiment, and Coloradocare was soundly defeated in November, so we are not going to be able to do what Canada did.

That's not negative thinking - that's called learning from the mistakes of others, and understanding exactly what you are dealing with.

I suggest that since you think anyone who is mean enough to give you the facts that just aren't supporting your parade is an 'enabler" and "handler" for the 1%, you may want to use the hide feature very liberally.

[pbmus]

64. You are still arguing with/for insurance... capitalism/healthcare does not work..

[ehrnst]

71. You seem foggy on the difference between "single payer" and "universal coverage"

There are many countries that use multiple payers for health care.

There is strong regulation, but some do use private, not-for-profit payers.

We have not-for-profit insurance carriers in the US: http://www.nonprofithealthcare.org/resources/BasicFacts-NonprofitHealthPlans.pdf

I agree that ideally, health care would be like education - a public guarantee, and private options. You don't seem to understand that about me, not that you read for comprehension as your emojis show.

What we disagree on is how realistic getting capitalism out of health care in this country is, and the feasibility of single payer. You seem to picture me wringing my hands, cackling like Mr Burns, thinking how I can single handedly stop the inevitable moral victory of single payer.

I'm younger than Mr Burns. Way younger. But I would guess I'm older than you are.

To decry the problems in capitalism is not the same thing as supporting single payer, and vice verca. I just don't want to see a more realistic path to universal coverage dismissed as evil, child gobbling, 1% "gaslighting." Because we could fuck up the chance for universal coverage in the name of "morally superior" single payer.

Yes, again - it's not really that different that the GOP having to demonize Planned Parenthood because of dogma, when those who are demonizing it would actually benefit from low cost contraception and cancer screening.


Is that clearer?

[pbmus]

73. There is one problem with your arguments. It is when you start acting republican..

You try to belittle my education or age... you are not older than me nor do you have a doctorate title like me...what you have is a dogma like conservative view of healthcare which is dying ...

[ehrnst]

74. You really haven't been reading my posts, just firing off angry rants

You certainly haven't learned much about research in whatever your doctorate title involved. Citations, etc.

But this is actually pretty accurate and will give you a better overview of the topic than an unsourced meme:

https://en.wikipedia.org/wiki/List_of_countries_with_universal_health_care


Good luck with that doctorate..... and really, truly - Obama was born in Hawaii, and Planned Parenthood is not selling baby parts, for all the good trying to talk facts to you is.

[pbmus]

75. Yeppers...

[URL=.html][IMG][/IMG][/URL]

[ehrnst]

76. Argument by meme. Did you learn that getting your "doctorate?"

And yes, capitalism has some real moral quandries - moral hazard among them.

You seem to think that I don't agree with that.

Perhaps if you read my posts before furiously pounding away at that keyboard....

[pbmus]

78. Facts are difficult for republicans...

[URL=.html][IMG][/IMG][/URL]

[ehrnst]

85. Calling me a republican? That's how you discredit someone who

Who points out the flaws in your argument?

[pbmus]

89. You have republican ideas is what I meant...on healthcare.

The only flaws have been to appease insurance executives and condone capitalism in healthcare.

[ehrnst]

98. Not hardly. You really haven't been reading a word I've written.

You are on rage fueled rant, and reading comprehension isn't really clear in that instance.

You need good vs evil, and for you that means agree with your dogma on single payer or bust, or disagree and you are a republican.

Not a good mindset for reality, which is why you react so angrily when someone simply points out the very real problems inherent in the single payer or bust dogma.

What did you say your doctorate is in again?

[pbmus]

100. You are good at gaslighting... lol...

[radical noodle]

125. Oh, but it certainly can be a choice...

... like the guy who chain smokes, drinks 24/7 and never eats anything other than the peanuts the bar provides. There are a lot of lifestyles that make illness their choice.

[pbmus]

128. And pizzagate is real... Hillary is running a brothel...

Suppose you can believe the earth is flat...like shaq...

[ehrnst]

134. That conforms to your vision of reality.

You sound far more like those that are convinced of Hillary and the DNCs evil with your rants against anyone that tries to insert facts into the conversation.

I'm beginning to wonder if that doctorate that you claim to have is from an actual university. You keep avoiding following through on my queries....

[radical noodle]

143. If you think that isn't true

let me introduce you to my cousin.

[pbmus]

153. That certain people want to be victims...oh yes, it's true that

Too many of us want to be needed...that is apparent in this thread.

[radical noodle]

158. Bless your heart...

there's something apparent in this thread but it has nothing to do with wanting to be needed.

[ehrnst]

174. Ha! (nt)

[ehrnst]

175. Some people just won't join in the pep rally!

All these 'facts' are harshing your all caps buzz, aren't they?

[Hassin Bin Sober]

18. Yep. There needs to be about 40 trash cans for overhead waste and profit.

Duplication of efforts - to waste money.

[jmbar2]

16. Suggestion for diagram

Needs to show profits going to CEOs and shareholders, and the amount that would be saved by cutting them out. Otherwise, fantastic!

[Yavin4]

17. It's not that simple.

At what level are you going to compensate the doctors and hospitals? What if healthcare providers refuse single payer patients and only want those with private health insurance or cash?

[pbmus]

20. You have just pointed out the gaslighting going on..

If everyone is single payer then NO private insurance unless like me you want the oligarchs to pay cash...

[Yavin4]

22. So you're going to force doctors and hospitals to accept single payer payments?

Or will doctors have a choice to not accept them? Also, the oligarchs can and will pay in cash for the best doctors and hospitals.

[pbmus]

24. We already have, they are called Medicare and Medicaid..

If you don't accept, I guess your practice is null and void...or only accept cash..

[Yavin4]

25. Some doctors don't accept Medicare

https://www.verywell.com/doctors-accept-medicare-insurance-3976280

[pbmus]

26. That's because we still are governed by oligarchs..

There gig is ending soon..and the sooner our supposedly elected officials understand this, then we can start putting the crooks in jail.

[ehrnst]

79. No, actually it's because physicians often have to submit invoices 3 times

As with my father's cancer treatment.

There are problems inherent in the system. You know, you can point out the problems in something that you support, and you won't be struck dead by lighting for heresy...

[pbmus]

81. Only because of our current healthcare system...

[ehrnst]

84. That's a circular argument. Are you sure you went to grad school? (nt)

[pbmus]

126. Another dig .... another carbuncle... gas lighter...

[ehrnst]

127. You were the one who whipped out "I have a doctorate"

as proof you knew more than anybody.

Still waiting for exactly what someone who can't cite a source to save their life gets a "doctorate" in.

[ehrnst]

83. Yes - my dads oncologist stopped taking Medicare patients after he finished with my dad's treatment.

There are some real issues with a system that refuses to pay invoices until the third time you submit them.

I would rather try to fix Medicare before trying to expand it to the whole population.

Hillary's plan of letting 55 and up buy into Medicare was the way to go - expand it out gradually, get more funding and buy in, along with expanding the enrollment in SCHIP.

[radical noodle]

117. I agree... and the extra we'd get from that

would be more people retiring early because they can afford healthcare on their retirement benefits... leaving more jobs for the younger folks.

[ehrnst]

69. Anybody that disagrees with you is "gaslighting" as far as you are concerned. (nt)

[pbmus]

96. We disagree to agree...that you know what gaslighting is...

[ehrnst]

99. Are you going to flick boogers now?

What is your 'doctorate' in again?

[pbmus]

103. Omg..you are making me sick...I need healthcare, I'll go to Canada..

[ehrnst]

113. Just don't go to Vermont..... or Colorado

Right?

[pbmus]

123. Soon to be California...

[ehrnst]

129. You mean California will dump single payer like VT and CO?

You got some inside info?

[LanternWaste]

39. You blithely ignore successful two-tier systems

You blithely ignore successful two-tier systems; which directly addresses your "it's not that simple" premise.

[Yavin4]

40. And you blithely ignore how the single payer system will compensate health care

providers and the doctor/patient disruption that it will cause.

[pbmus]

49. Dr/patient disruption is an oligarch talking point, and used to gaslight...

Medicare, Medicaid, VA, CHAMPVA, TRICARE, CONGRESSIONAL MEDICAL and many more...

[ehrnst]

160. ERMEGERD!!!! OLIGARCH!!!!

YOU HAVE DISAGREED WITH ME AND ARE THE DEVIIIIIIIIIIIIIILLLLLLLLL!!!!!!!

I shall call you that name, and you will be SHAMED for your dissent!!!!

After all, that's what DEMOCRACY is - absolute conformation with the MANIFESTO!!!!

[ehrnst]

184. Good luck with logic. (nt)

[Kimchijeon]

21. K&R YES

Yes, this cannot be stressed enough!!!

[Jonny Appleseed]

27. How do elective or advanced/experimental procedures work in this system

Like if I want my doctor to make me an Iron man heart instead of a pacemaker?

[pbmus]

28. LOL...since the big con and the oligarchs are cutting research

investments...you might need to wait another 2-4 yrs..

[ehrnst]

176. Yeah, really bodes well for getting single payer through in this administration, doesn't it? (nt)

[2naSalit]

29. Because, greed....nt

[pbmus]

30. Well , that is because greed and avarice is promoted...

Look at the main reasons why we have the big con and the level of corruption in our system..

If humans want to survive another millennium, then we must start realizing the eternal truth that these lead only to destruction..

[ehrnst]

177. I see that we are fortunate enough to have someone who has the corner on "eternal truth" right here

on DU...

It's always easy to point out what is wrong, but not so easy solve it.

Even with all the "positive thinking" and ALL CAPS in the world.

I'm always suspicious of someone who says they 'have the answer' - I trust someone more who says, "Why hasn't this been solved, and what lessons can we learn from going forward?"

[Louis1895]

32. Is there a cost analysis of this?

I think this graphic along with numbers explaining the administrative costs at each step would demonstrate a huge savings!

Each arrow in the graphic is money spent on administration. I cannot count the actual number of arrows in the top graphic.

[mwooldri]

37. I'm sure there is but the numbers already speak for themselves

NHS England covers 53 million people on an annual budget of £123 billion (about $165 post Brexit).

Medicare covers 56 million people on an annual budget of $650 billion. Medicaid covers about 70 million people on an annual budget of about $650 billion.

Therefore one can see that if the NHS was replicated across the USA, the US government could cover everyone with no increase in taxes.

Only one reason why it won't happen here: money. And that you'd have to nationalize nearly all the hospitals and lots of other facilities.

[pbmus]

43. Are Medicare and Medicaid working???

[ehrnst]

173. Depends on who you ask, and what you mean by "working."

Many physicians will not take Medicaid patients because of the lower payments, and the issues involved in getting paid in a timely manner.

https://www.advisory.com/daily-briefing/2015/04/06/docs-medicaid-patients

Many physicians are phasing out their Medicare patients because of the issues with getting paid in a timely manner.

http://kff.org/medicare/issue-brief/primary-care-physicians-accepting-medicare-a-snapshot/

If you mean by "working" is that people are able to see a physician for health care while on those programs, then yes, if you don't count how hard it is to find a physician that accepts patients in those programs.

[MindMover]

164. Why do you say, have to nationalize all hospitals...?

Are we doing that with our current VA system... I know many would like to see that happen!

[mwooldri]

171. If one was to replicate the NHS in the USA...

... one would have to nationalize a lot of hospitals and clinics. Doctors would be mainly government contractors. Other health professionals would be direct government employees.

Rather than reducing the size of government, you would create the world's largest employer. Not too shabby since we already have #1 (US armed forces). There won't be many executives on multi million dollar salaries. Rather than merge, Aetna and Cigna would probably shut down. There would be job losses as all the people to process insurance billing would no longer be required, and there would be less debt to collect on. Hospitals would know how much they would receive for X procedure and can budget appropriately. The NHS is more like a HMO with a primary care physician as your gateway to care. However the more patients a doc has, the bigger budget they have.

Frankly I don't think even Bernie Sanders could expand government that big. It won't happen in the USA. There are other things we can do to control costs... Medicare for all with the power to negotiate price is a good way IMO. There has to be a place for private medicine in the US system, even if it turns out to be a lot of contracting.

[ehrnst]

181. This will fall on deaf ears on the part of the OP.

All those caps were supposed to drown out any sort of rational discussion.

[IronLionZion]

33. But what about the people who want to get filthy rich from it?

But seriously, there are a hell of a lot of people making money from it. It didn't just become 1/5th of our economy through spontaneous generation. Those people will spend money to fight against meaningful reforms. Just look at how hard they fought against the ACA, demonized everything and lied about it, shut down the government, the whole tea party sprung up to oppose it.

[ehrnst]

34. A 'simple' as rerouting all the roads in a large city to make them a neat and tidy grid.

That's not "gaslighting," and that's not Oligharcy.

It's one of those things that sounds much easier than it really would be, especially among people with no health policy background.

Just as 'simple' as the idea that getting rid of the largest abortion provider in the country, Planned Parenthood, will reduce or eliminate abortion. And just as grounded in fact.

We are supposed to be the ones that check the data to be sure that it's not just wishful thinking, or confirmation bias.

I have. I wish that demolition of our current very established health care infrastructure (inefficient and flawed as it is) to set up single payer was indeed possible, and is as simple as it sounds.

It's not.

[pbmus]

42. In your mind, it is not possible.

[ehrnst]

44. You do know the power of "positive thinking" does not actually alter reality, don't you?

I understand that Single Payer is dogma, and to even doubt that it would be simple is thoughtcrime.

Wanting something to be simple badly enough does not make it so, no matter who tells you that....

Meanwhile, at the other end of the internet, reasonable GOP members are being shouted down about Planned Parenthood.




Edited to add: There are health policy analysts who would love to see it, but are able to understand the obstacles:

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

[pbmus]

50. The power of positive thinking not only is proven to work...

It has changed lives all over the world...

[ehrnst]

58. It's not a substitute for being informed with facts, and acting in accordance with reality.

Many pray that Planned Parenthoods will burst into flames.

Still not going to happen.

[radical noodle]

121. ehrnst

you have the patience of a saint.

[ehrnst]

130. Thank you.

To be honest, it's a good workout for dealing with family members who read nothing but the Intercept.

edited to add: I LOVE your latest definition of Puritopian. I may deploy...

[pbmus]

135. You are most welcome...

[ehrnst]

147. More booger flicking?

Was this doctorate of yours gotten by mail order?

You still haven't come clean on the 'three letters" after your name that you seem to think makes you immune to facts.

Some men....

[radical noodle]

144. Go for it! n/t

[ehrnst]

148. Done. As expected, no response.(nt)

[taught_me_patience]

72. Unfortunately, it seems you're talking to the wind

The OP is only interested in fantasy and blaming the "oligarchs". He/she has no interest in history or discovering why things are the way they are in order to inact the kind of change that would make the system better. Your posts in this thread have been great and it's probably not worth the time arguing with the OP.

[ehrnst]

102. Oh, it's a good stress relief

keeps the debate skills sharp, and the facts fresh at hand.

Truly - this debate on the left is going the same place as the demonization of Planned Parenthood on the right.

[The Wizard]

35. Our Byzantine system

leave much more room for legislators to have bribe money sent to off shore money laundries. When a crime (s) is / are committed, follow the money.

[iluvtennis]

36. Nice. Our current system is all about the MONEY MONEY MONEY for ins companies, pharmas, etc

[Marcuse]

38. The health insurance industry is against single payer, just like...

The bookies were against government Off Track Betting. The numbers bankers were against government lotteries. The drug cartels are against the legalization of relatively harmless substances. It is to be expected.

[ancianita]

41. A sick country can never be great again. It can be pacified by dictators and capitalists, though.

[FakeNoose]

54. This puts the insurance companies out of business

That's un-American!

This takes most of the obscene profits away from Big Pharma.
That's un-American!

This puts every middle class and poor family on the same level as the one-percenters.
That's un-American!

I mean, what could we be thinking anyway?

[pbmus]

55. Really, what would we be thunk in...

[ehrnst]

94. Making that huge a changs to a health care system that is 18% of our GDP

There will be negative consequences to many - mostly those at the lower end of the pay scale.

That's the case for making it gradual.

[pbmus]

109. Income adjusted means your premium is adjusted to your income..

I know that type of thinking is difficult for conservative thinkers...

[ehrnst]

112. By "conservative" you mean someone who disagrees with you.

And I'm talking about the people who will lose their jobs. If you think that a corporation is going to cut their bonuses, and not fire the lower paid work force, you don't understand capitalism.

Is that clearer?

Keep on banging your head. Maybe you'll get tired of it and read before firing off your rant.

[liquid diamond]

60. How many times are you people going to

keep asking this question? You people being those who think such a system is possible in America.

I'll give you 3 reasons why it will NEVER HAPPEN HERE.
1. Many people don't want to pay higher taxes to pay for other people's health care. They could be motivated by greed or racism.
2. Inurance companies are a multi-billion dollar industry. They are not going to give up their financial interests for the good of the people.
3. Republicans control the house and the senate. You would need every democrats' support AND a significant number of republicans to make this a law. Considering how they fought to prevent the ACA, that's not likely to happen.

[pbmus]

62. Single payer has happened and will be the law of the land sooner than you think...

[URL=.html][IMG][/IMG][/URL]

[taught_me_patience]

66. Many of these countries are not single payer

"Universal Healthcare" doesn't equal "single payer".

[pbmus]

67. You are correct, however, There healthcare costs are much lower ..and prescription drugs

Are not starving grandma and grandpa...

[ehrnst]

86. But.... they are doing it with something other than single payer, yes?

Did I hear you agree with someone on that?

[qwlauren35]

170. What is the difference?

Between Universal Healthcare and "Single Payer"? I sense that there are a few different ways to arrive at the same end. Please give details if you can. I think it would be educational here.

[ehrnst]

172. Universal Healthcare is the blanket term for "everyone having affordable health care"

"This includes financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all," according to W.H.O.

Single payer is one way to do that. Most countries use combinations of government subsidies, private and non-profit payers. There are varying levels of success in achieving the W.H.O. definition:

https://en.wikipedia.org/wiki/List_of_countries_with_universal_health_care

Medicare isn't even really single payer, because one needs to purchase supplemental private insurance plans, which are subject to government regulation, for dental, hearing, optical and rx.

The only real single payer plan we have in the US is active duty military (think MASH), and the VA which is also considered socialized medicine, because the physicians work for the government.

It's worth noting that one of the few true single payer systems in the world, Canada, only got federal single payer after all the individual provinces had established their own independently, which took nearly 20 years.

[qwlauren35]

178. Thank you.

I went to Wikipedia, and was frankly still confused. As Trump said: "I didn't know it was so complicated". If I understand you correctly, single payer may be THE most expensive way to do it, and no one in the US is going to be willing to be taxed enough to cover it.

I also hear your point about health care being a major part of our GDP. Healthcare services can't be shipped overseas, and it has high demand vs. supply. It makes money, which is good for the economy and all who are employed because of it, but there is a lot of overcharging that we don't seem to know how to address. It's hard to make healthcare competitive such that the prices would drop - unless, for example, we let other countries' companies compete with our pharmaceuticals, and we let other countries' companies compete with our health insurers. I think that's what happened in Ireland.

I think I would like to see overwhelming ground-up support for single payer to the point where it drove a solution that provided universal healthcare, even if it's not the single payer method. If we could force Congress and the Senate to listen to the people, in addition to the lobbyists, we would have a shot at something viable.

[ehrnst]

87. Argument by meme again.

I answered this above, and you 'sploded!

[PoliticAverse]

138. I was assured that single payer would "never, ever come to pass" in the US. n/t

[ehrnst]

183. It hasn't thus far. (nt)

[ehrnst]

95. Don't bring reality to rain on the anger parade!!

Really - you are going to be called a republican soon.

[pbmus]

97. You are very good at confuscation ...

[ehrnst]

116. Was your thesis committee Larry, Moe and Curly?

Because I think that's the only way you got your "doctorate,"

[pbmus]

132. Another slam..sticks and stones...

[ehrnst]

179. Still haven't come clean about that "doctorate"

you whipped out for cred.

[liquid diamond]

141. I know. They never have an intelligent response

to those points. They just say shit like, "What? We shouldn't try?" or "No we can't!"

No fucking details on how to convince greedy and heartless republicans to vote for this law. No details on how we will convince taxpayers to fund universal healthcare for ALL. Just wishful thinking.

They keep pointing at other countries with universal healthcare, but fail to acknowledge our political, cultural, and financial differences between us and them. We suffer from political division, racism, and corporate greed. Those differences are why we don't have universal healthcare here AND NEVER WILL.

[jimlup]

63. Because of Insurance company profits

it is really simply about that bottom line. We must pay the robber barons otherwise we can't have any pie.

[pbmus]

65. Capitalism/healthcare..yeh sure, .that works so well...

[ehrnst]

90. Other countries have capitalism and universal health coverage.

Do you need a list? I know you love those.

[pbmus]

91. We agree, ...

[ehrnst]

92. Good, because while you are building the barracades, people need health care.

There are five capitalist countries with universal coverage, by the way.

[pbmus]

122. Again false accusations...

[jimlup]

118. Indeed but the rich have the power and the rich

are the insurance companies themselves.... so I honestly don't know how the problem can be solved. They are never going to give up their power voluntarily. They will lie, cheat and even steal to hold on to it. This holding on to power is what we are witnessing right now in the Trump administration. They've lied and cheated their way into office. Now they will lie and cheat us out of everything that they can. They would take our health care if they could.

[ehrnst]

124. There is the concept of the "wicked problem" that is incomprehensible to binary thinkers

I think healthcare coverage in the U.S. is one.

Desegregation was another. Because of Brown v. Board of Education, many southern school systems just shut down public schools, and pushed taxpayer money to private "Christian academies" in order to maintain segregation.

As a result, another generation of children of color were denied education, that might have gotten at least some education if not for Brown.

And we are still dealing with economic segregation of schools. Not that Brown v. Board of Education was wrong. It may have been the only way to push desegregation forward. But there were huge costs, and those costs were not taken into account.

Sometimes all you have are bad/less bad options. I thought of that when Hillary was pilloried for some of the Obama administration policy decisions. Sometimes all the options you have are bad vs. worse.

Of course someone who only sees Good/Bad won't get that nuance. If we ignore the potential very bad things that will absolutely happen if we try to turn the freighter that is our health care system too quickly, we will lose the opportunity to reform it again.

The average time between major health policy reforms is NINTEEN AND A HALF YEARS.

We cannot afford to fuck it up. Vermont is a cautionary tale.

[MindMover]

165. So, what is your answer to healthcare?

You have castigated the OP and ridiculed the very idea of single payer. What is your opinion of what to do about healthcare. Or do you have one?

[pbmus]

169. The poster along with some buddies like to ridicule and holler insults..

Thanks for your question.

[Initech]

80. Greed and profit get in the way of rational thought.

[pbmus]

82. AMEN...AND I SAY AMEN...

[ehrnst]

88. Thou shalt not commit the heresy of disagreeing with the single payer creed.

Amirite?

[pbmus]

93. Lol...was agreeing with the obvious fact of greed in our Healthcare...

[ehrnst]

146. Clearly the banging of your head in the furious emojis

has affected you.

Those meetings are free, you know.

[BruceWane]

101. Not really that much difference in the charts

The only difference is that you lump medicare, medicaid, and Acme Health Insurance into one entity.

Which is pretty much what will happen if we go to single payer - a large part of "Acme Health Insurance" will remain.

It's not like the existing administration for medicare and medicaid can just take on the entire US population in a snap - there will have to be a massive expansion of the administrative entities.

So either
A)a lot of the people currently working for insurance companies will be recruited and hired by the government - after all, they've got needed experience in doing this stuff, it'd be silly to go out and hire everybody off the street, with zero experience. Even if you hire lots of experienced people, you're still tearing down and re-creating a very large administrative structure, and that doesn't happen easily or quickly.

Or

B) the government contracts out the care management to existing insurance companies. Which they are already doing
with portions of medicaid in many states. So basically an expansion of already existing practices. This is a lot more likely because it's quicker and easier, and also easier legislatively because then you're at least keeping more things in the "private sector" which will somewhat appease the folks who aren't on board with full-on socialized health care.

When you take into account the likelihood of actually getting something passed into law, this type of single-payer system is the only feasible option. Having all the money controlled directly by the federal government ain't gonna happen.

[pbmus]

104. Quicker and easier is what the big con and his associates thought...

Aerial view of TrumpCare

[URL=.html][IMG][/IMG][/URL]

[procon]

106. Eliminate the middle man; that's always been a huge way to cut costs. nt

[pbmus]

107. That is precisely the problem...too many of those critters.

And they have lobbyists and the lobbyists have lobbyists and then there are the oligarchs...

[BruceWane]

111. Yeah! Eliminate the middle man!

Which middle man is that?

The one that negotiates healthcare costs ahead of time and pays them, so you don't need to get bids on a procedure, take the lowest bidder (if you dare), then pay your bill out of your own pocket?

If you want to "eliminate the middle man", you need to drop health insurance altogether and start paying all health care costs directly out-of-pocket. Just you and the healthcare provider - see, no middleman!

Single payer doesn't "eliminate the middle man".

[pbmus]

114. It eliminates many middle men that are taking and not contributing...

anything but lips moving...and many times those lips moving are spouting nonsense...

[ehrnst]

115. And that middleman

is the government, which has republicans wanting to chip away at it.

The ACA tried to get an independent, non partisan committee to negotiate costs, the GOP was able to block it.

Until there is true independence from future administrations (as we have seen this year....) and the Hyde amendment is overturned, single payer will not work for patients, especially women of childbearing age.

That's one reason Coloradocare was opposed by NARAL and Planned Parenthood. Colorado law prohibits any state funds from covering abortions that don't threaten the life of the woman or girl that is pregnant. Until that law is overturned - as well with the Hyde Amendment (which survived a dem house/senate/White House) - single payer at the federal level will leave women out in the cold.

[BruceWane]

108. Greed

Please feel free to nominate your person of choice to serve as "official arbiter of greed".

Not saying that there isn't greed involved in health care.

But are doctors greedy? How much should they make?
Are nurses greedy? How much should they make?
Are the people who manage hospital payroll greedy? How much should they make?
Are the people who handle supplies - bidding, ordering, shipping, recieving, inventories, etc. greedy? How much should they make?

And on....
And on...
And on...


It's that simple?

Sure, you can make a handy chart with a single element for "doctor's offices and hospitals". But it's not really that simple........

[pbmus]

110. Well of course there is GREED...

Who best to quantify greed.... insurance companies or government ... I still choose government...

But the gas lighters will argue , oh no, governments tooooo big already they can't handle it...but capitalists can...

[ehrnst]

119. Who is arguing that?

Do tell - I know that "gaslighters" is the name you call anyone that dares to bring up alternative solutions, but please provide a link.

Also, since you have a 'doctorate' you can quickly find the proposed solution to the issues in payment delays/refusals that health care providers are having when submitting invoices.

ALL CAPS rant with non-sequitur with several smilies in 3...2...1....

[pbmus]

120. Delays are due to many reasons...however the numero uno main one is...

'Lack of proper funding to hire personnel '

And who controls that funding....guess...

[ehrnst]

131. Why don't you tell me?

And then tell me how you fix that.



Also:
From the Urban Dictionary

http://www.urbandictionary.com/define.php?term=Puritopian


A Puritopian is a self-described liberal or progressive whose political orientation is to be angry, dissatisfied and unhappy with the state of the nation, because in their view, liberal policies are not being implemented quickly or forcefully enough. They have particular contempt for Democratic presidents.

Puritopians dislike Republicans but reserve their greatest disdain for Democratic presidents, whom they relentlessly attack for not meeting a set of ideological goal posts that are constantly adjusted to ensure that the president will be deemed a disappointment, "not progressive enough" or "just like a Republican" no matter what policy achievements are made.

Puritopians have an affinity for 3rd party politics as a way to punish Democratic presidents. They are especially hostile to President Obama and deem anyone who expresses a lack of ill will toward him to be "Obamabots" and enemies of liberalism.

[pbmus]

139. Your politician directed by his oligarch pushes the no button on funding...

2018 and following the rule of law will start the locomotive ,,,

however the biggest change is happening...

[ehrnst]

142. I can tell when I've hit a nerve when you whip out "oligarch"

The same effect can be achieved with pointing to anyone that dares to present some facts that don't confirm your bias and scream, "Deviiiiiiiiiiiilllllllll!!!!!!"

Rolling your eyes adds greatly to your credibility - second only to all caps.

Aren't you due for evening vespers? Just don't drink this time before you go....

[pbmus]

150. LMAO...you are funny...should be a comedian...

[ehrnst]

159. More booger flicking.

You don't really have a 'doctorate' do you?

Thought so.

[radical noodle]

145. I'd love to see where you got that gem..

'Lack of proper funding to hire personnel '

[pbmus]

151. 'Truth doesn't stop climate change'

Another gem ...they just roll off my back...

[ehrnst]

180. "Facts don't care if you believe in them"

They just are. Even if they contradict your cheerleading, and complete intolerance of any dissent.

[dubyadiprecession]

133. Show this to a single payer foe on the right...

and you will only get paranoid conspiracy theories about your single payer organizational chart.

Sorry, they are complete idiots.

[ehrnst]

136. Unfortunately, the poster of the OP makes no distinction between

those that have genuine, fact based concerns with concentrating on single payer as the only way to universal health coverage with blood thirsty, republican, hyper-capitalist witches.

It doesn't do us any good to argue by uncited meme and lots of all caps.

[pbmus]

149. Yep.

[JustABozoOnThisBus]

152. Replace the words "Single Payer" with "Veterans Administration"

and the diagram is not too far from fact.

[pbmus]

154. Exactly, I have said VA many times in the thread...

Love your handle...

[qwlauren35]

166. Thank you for posting this.

I posted this on my Facebook page and two of my Republican friends said they could get behind it. I was completely amazed.

I also gave folks the link to the page for the Congressional Single Payer bill from last January, showing the number of co-sponsors. No Republicans yet, but my fingers are crossed. Only takes one to start an avalanche.

https://www.congress.gov/bill/115th-congress/house-bill/676/cosponsors

[pbmus]

168. Thanks to you and your efforts...Yes We Can.

[Kimchijeon]

185. I agree with you, and it needs to be repeated- it is THAT SIMPLE

No matter what the "but but but" excuses, we gotta ignore that. No more excuses and self-defeatism. We want this, it's simple, let's fuckin' do it, go for it, demand it.

IT IS JUST THAT SIMPLE.