M4A - The Walmartization of healthcare

[dansolo]

I have been trying to pin down what it is about the M4A that bothers me from the cost side, and it just dawned on me. M4A will treat healthcare providers the same way Walmart treats their suppliers. In the case of Walmart, the motive to keep costs down is profit, and with M4A, the motive is to minimize tax increases to pay for it. But the problem is that it puts the onus of cost reduction on the providers. Walmart reduces costs by pressuring their suppliers to reduce how much they can charge for their goods. Because Walmart has such a dominant position in the market, the suppliers have no other choice but to comply, even if they will get less than what it costs to produce. They are then forced to reduce staff, reduce quality, or cut corners in other ways to stay in business. M4A will do the same thing to healthcare providers. It would be a disaster.

[jcgoldie]

1. So now we are comparing government provided health insurance...

...directed by democratically elected officials to... one of the most egregious examples of excessive capitalist hegemony by a private corporation driven entirely by profit motives. And we are making this argument in support of protecting private insurance companies continuing to make the decisions which dictate our health care and treat it as a commodity rather than a basic human right and need. That makes complete sense.

[BlueMTexpat]

2. Some are really going out of

their way to smear MFA. They're contorting logic in a way that reminds me of how a certain political party is acting wrt impeachment.

How truly sad!

[Demsrule86]

41. I find it much sadder that some equate disagreement about policy between Democrats as

a reason to label our own as 'acting like the other party (IE Republicans) ...not true and I think this sort of response shows clearly what Biden meant in his criticism of Warren and some of her supporters...being as being elitist...my way or the highway...either you agree with us or you are 'bad'; why you should be running and /or I suppose voting in a different primary if we carry this to a logical conclusion. Calling Democrats who disagree with some policy republicanesque is much sadder IMHO than the fact that not all Democrats are on the same page in terms of policy. Democrats will not always be in agreement on specific policy and that is not a reason to slam them...not candidate nor Democratic voters.

[Demsrule86]

32. Care would be reduced...I do not believe our care will be as good for everyone under M4A. Older folk

and the chronically sick would be at risk. And the wealthy will have better care ...count on it.

[jcgoldie]

35. why would "older folk" be at risk under medicare for all when they already have medicare?

The entire concept of universal single payer health care is to provide for the chronically sick who have difficulty securing private insurance. Democrats believe that government should provide basic human rights. At least that is what we used to believe until it became inconvenient for a lot of people around here based on the stance of their candidate.

[Demsrule86]

40. Medicare for all is not a great program. And baby boomers retiring in droves with no pension and

in many cases few savings are not going to be able to afford Medicare in its current form. Also, I assume medicare for all would include seniors...and basic care is just that basic...we can do better and not risk our next election...Trump must lose. I look at the cost associated with Medicare and I double it for hubs and me...it will be expensive as it is now and as I shared I have not been impressed with my sister in laws care under Medicare after a badly broken leg. I am too young to be on it thankfully.

[PhoenixDem]

3. Walmart is too upscale

M4A is more like a dollar store.

[lonely bird]

4. Sigh...

Basically, this country can't walk and chew gum at the same time.

Just like education, we can't bear to look at other countries and draw on what they have done when faced with similar problems.

Oh, no, we can't do that 'cuz we're 'Murica! We would rather screw things up worse than admit some other country has a better plan.

So, why not a plan like Canada's, for instance?

[George II]

16. Canada has a shortage of doctors and medical facilities. Next?

[lonely bird]

45. Do you know why?

https://www.cbc.ca/news/canada/british-columbia/bc-doctor-shortage-medical-fees-1.4100251

2017 article stating Canada is churning out doctors but they aren’t going into general practice. Maybe that is the problem? Or maybe because costs for everything skyrocket. Capitalism has this small little glitch called decreasing margins. Figure out how to cure that along with paying everyone enough so that they don’t have to live poorly. The entire West as well as the alleged next center of the world, East Asia, is going to run headlong into demographic issues, energy issues, healthcare issues, food & water issues because the primary resource that is exploited and rationed is money and power over money.

Wars are fought for a variety of reasons. The next one will be far more urban as people continue to move to cities and it will be bloody beyond our imagining. The cause will be access to resources controlled by the Superclass.

[George II]

48. You asked "why not a plan like Canada's", I pointed out that Canada's system isn't perfect.

[Hoyt]

31. Like Canadian health system. Although, we should cover prescription drugs, which Canada does not.

[Hassin Bin Sober]

5. Walmart workers have to camp out in parking lots for three days to get seen by a free doctor

And beg for money when their family members get sick.

But won’t somebody think of the hospital groups?

[LanternWaste]

12. Those hospital groups better be respectful... so they don't get shot.

Thankfully though , those hospital groups aren't hanging around on street corners, but they are voting... and as Ms. Sanders said, it's not important who we vote for as long as we vote.

[George II]

6. There are unintended consequences with this or any "we'll decide what the rates are"...

...plan.

Fewer people will go to medical school to become doctors
Fewer people will go to nursing school
Fewer treatment facilities will be established, some may go out of business
There will be a lot less medical research being done
The pharmaceutical companies will cut back on drug research

Eventually there will be a shortage of doctors, a shortage of nurses, a shortage of labs, treatment facilities, hospitals, few drugs available to cure diseases.

Maybe an oversimplified analogy, but let's say the local restaurant offers a steak dinner for $25.00. The government comes in and says "you can only charge $20.00 for steak dinners". The owner of the restaurant might say, "screw it, I'm going to close and go into another line of business."

People complain about the "quality" of health care now, what will it be when those providing it have to cut corners to do so and there are less facilities available to the general public?

[Dr Hobbitstein]

7. No shortage of medical professionals/researchers

in countries with similar plans.

This argument has always been based in libertarian/Ayn Rand ideals.

If you became a doctor to be wealthy, you’re probably a shit doctor.

[George II]

8. Very little research - both medical and pharmaceutical - goes on outside the US.

Doctors do NOT become so to "become wealthy", but they DO hope to make a living commensurate with their training and experience.

That you boil it down to "becoming wealthy" is odd.

[Dr Hobbitstein]

9. Well, that was the gist of your argument.

You might not have said wealthy, but it certainly was implied. Doctors in countries with similar programs do just fine.

We may be #1 in biomed research, but China is just behind us, followed by Germany and the UK.

MFA is better than private insurance by far. Other countries with similar programs prove that.
Licking the boots of the insurance companies is a strangely USA specific thing.

[George II]

13. BTW, you might want to rethink your first statement:

https://www.theguardian.com/society/2019/oct/13/nhs-consultant-shortage-rural-coastal-areas

New report reveals alarming shortage of country doctors

Hospitals in rural and coastal Britain are struggling to recruit senior medical staff, leaving many worryingly “under-doctored”, a major new report seen exclusively by the Observer reveals. Some hospitals in those areas appointed no consultants last year, raising fears that the NHS may become a two-tier service across the UK with care dependent on where people live.

https://www.thespec.com/opinion-story/9055996-the-solution-for-canada-s-doctor-shortage-is-abroad/

The solution for Canada’s doctor shortage is abroad

Canada is dangerously short on doctors — and isn’t training enough new ones to close the gap

Canada has fewer doctors per capita than almost every other wealthy nation. And this doctor shortage will worsen in the coming years. Canadian medical schools aren't producing enough physicians to meet the needs of our growing population.

To ensure that patients receive timely care, government officials must welcome more physicians educated at international medical schools.

The doctor shortage threatens our nation's public health.

Nearly 16 per cent of citizens aged 12 and older don't have a primary health care provider, according to the most recent figures from Statistics Canada. In Quebec, over one-quarter of residents lack a primary care provider.

Canada also lacks enough psychiatrists. Ontario, for instance, is short 200 psychiatrists. That gap will grow to 350 by 2030.

The doctor shortage is particularly severe in rural communities. While 18 per cent of the population resides in a rural area, fewer than 10 per cent of the nation's physicians practice there.

[Dr Hobbitstein]

19. Keep licking those insurance company boots, George.

It’s time we evolve as a country and join the rest of the civilized world. Health care is a right, not some added expense from private for-profit insurers.

[George II]

21. Just presenting cold, hard facts, Dr.

[Dr Hobbitstein]

22. "Facts". nt

[George II]

24. Did you read the information posted and the links provided?

[Dr Hobbitstein]

26. About rural doctors in the UK?

You know what else is short in rural areas? People.

We have the same exact problems in the US. Rural areas don’t exactly attract a lot of people.

You’re going a LONG way to defend the insurance companies on this one.
I’m so sick of centrists.

[George II]

28. There were two articles cited, one about the UK and one about Canada....

And in none of my posts have I even mentioned "insurance companies". So sorry you're "sick of centrists", which make up about 60-70% of the Democratic Party.

[George II]

34. "Centrists are just right wingers who find the Republicans too extreme" - thanks for ANOTHER...

...even less subtle insult.

[Cha]

37. Wth! Who says that?!

[Cha]

38. Too Bad, Hobbitstein.. Moderates are who WOn us the BLUE

WAVE House Victory in 2018, Flipping 40 or more red seats to BLUE.. and why we Gov Elect Andy Beshear by approximately 5,000 Votes!

And, why we're able to have Impeachment Hearing on the monster in the WH NOW.

[still_one]

44. Nice divisive post

[George II]

36. What is unfactual about what I posted, other than that you think I'm "licking the boots"....

...of insurance companies, even though I've never mentioned them.

[Cha]

39. Oh really, Hobbitstein.. is that the best you can come up with?

[ehrnst]

43. False dilemma PLUS attacking a straw man.

A twofer!

[melman]

15. Did you seriously just bust out the "research" talking point?

LOL

[George II]

17. If you read my post, yes, I did "seriously just bust out the "research" talking point"....

Got anything to counter that other than calling it a "talking point"? I'll be here.

[Dr Hobbitstein]

20. Yes. He did. Galt's Gulch and everything. nt

[George II]

23. Thanks for the not so subtle insult, I appreciate it.

[melman]

25. Why would you be insulted by that?

[Dr Hobbitstein]

27. Well, you described exactly that, so... nt

[aidbo]

10. Hot take!

[Dr Hobbitstein]

11. Universe brain! nt

[Hassin Bin Sober]

33. Lol.

[TidalWave46]

14. Just the opposite.

Right now we have a system That puts a handful of shiny things on the shelf with each one requiring some form of compromise. If you are doing will you can get some Chobani. If things are a little rough you can get some generic yogurt. If you don't have a pot to piss in you can look.

Or you can go with the off brand tub of mac and cheese, also known as the catastrophic plan. Either way, Walmart is guaranteed their profits.

[redqueen]

18. Yes, it does require the healthcare industry to change.

However reducing staff or quality isn't the only way to reduce costs.

One way Yang proposes, and which I agree with, and possibly other candidates propose the same thing - is shown below.

With a shift to a Medicare for All system, costs can also be controlled directly by setting prices provided for medical services. The best approach is highlighted by the top-ranked Cleveland Clinic. There, doctors are paid a flat salary instead of by a price-for-service model. This shift has led to a hospital where costs are visible and under control. Redundant tests are at a minimum, and physician turnover is much lower than at comparable hospitals.

Doctors also report being more involved with their patients. Since they’re salaried, there’s no need to churn through patient after patient. Instead, they can spend the proper amount of time to ensure that each patient receives their undivided attention and empathy.

[KPN]

30. Lame. Really? You are equating the federal government with WalMart? No credibility.

[wellst0nev0ter]

42. Some people just love $400 insulin

It's truly amazing the lengths people go to defend the utterly indefensible status quo.

[Lancero]

46. But but but... If they can't charge people that much, they'll go out of business!

If you think prices are bad now, just see how worse it'll get once they have to start cutting corners!

[Lancero]

47. As bad of a company as they are overall...

Their price leveraging is the only reason a lot of people can afford their medications.