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Polarized healthcare solution?

Hawk8595

HR Heisman
Dec 3, 2008
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http://www.businessinsider.com/single-payer-health-care-2017-7

Before you righties say oh noes, read it. I think it may surprise you.
Article...

While progressive groups have long pushed for a single-payer system in the US, Democratic Party leaders are starting to suggest they are open to advocating such a system.

"We're going to look at broader things" for the nation's healthcare system, Senate Minority Leader Chuck Schumer said on ABC. "Single-payer is one of them."

Some of the richest and most powerful Americans — many of them Republicans — have recently brought up the possibility of shifting to a single-payer system. It comes as the Republican-controlled government has spent months attempting to revamp the US healthcare system with legislation that would move the system further from single-payer.

Perhaps most striking was Aetna CEO Mark Bertolini recently saying at a private conference that the US should start considering the idea.

According to Vox's Sarah Kliff, Bertolini told Aetna employees at a town-hall-style meeting in May that he thought "we should have that debate" about single-payer "as a nation."

Kliff said that based on his comments, Bertolini did not support a total government-run single-payer system but could be open to a private-public system used in some nations.

"So the industry has always been the back room for government," Bertolini said. "If the government wants to pay all the bills, and employers want to stop offering coverage, and we can be there in a public private partnership to do the work we do today with Medicare, and with Medicaid at every state level, we run the Medicaid programs for them, then let's have that conversation."

The idea, for Bertolini, is that the government would finance insurers to provide the care, similar to Medicare for all. The Aetna CEO, however, said he didn't think total government-run healthcare was the solution, which makes sense, considering it would put him out of business.

"But if we want to turn it all over to the government to run, is the government really the right place to run all this stuff?" Bertolini said. "And that's the debate that needs to be had. They could finance it, and if there is one financer, and you could call that single-payer."

The shift is understandable for Aetna, since for the first time, most of its business is coming from government programs like Medicare and Medicaid. Additionally, as Bertolini likes to point out in interviews, the insurer was the first Medicare provider in 1965.

In addition to backing from the CEO of one of the five largest public insurers in the US, the single-payer idea has also received recent support from the business titans Warren Buffett and Charlie Munger.

Munger, a Republican, railed against the current US healthcare system at Berkshire's annual meeting on May 6 and in subsequent interviews said the country should shift to single-payer.

"The whole system is cockamamie," Munger said in an interview with CNBC's Becky Quick in May. "It's almost ridiculous in its complexity, and it's steadily increasing cost, and Warren is absolutely right. It gives our companies a big disadvantage in competing with other manufacturers. They've got single-payer medicine, and we're paying it out of the company."

When asked by Quick if he supported single-payer, Buffett said, "I personally do."

Buffett also bemoaned the fact that healthcare costs make up roughly 17% of the US's gross domestic product — according to the Centers for Medicare and Medicaid Services, it was 17.8% of GDP in 2015 — much more than any other developed nation. The Berkshire CEO said these increased costs for businesses, rather than the corporate tax rate, were holding back American competitiveness.

Even President Donald Trump, who has supported Republican-led efforts to overhaul the healthcare system, has praised Australia's public-private system in a meeting with Prime Minister Malcolm Turnbull and in subsequent tweets.

"I shouldn't say this to our great gentleman and my friend from Australia, because you have better healthcare than we do," Trump said in his meeting with Turnbull on May 5.

After critics noted that Australia has a universal healthcare system in which the government pays roughly 70% of all costs, Trump used Twitter to defend the comment the next day.

"Of course the Australians have better healthcare than we do — everybody does," Trump tweeted.

With Republican control of the presidency and Congress, much of the talk about single-payer is likely to amount to just talk on the national level. There is some action on the state level, though — both California and Illinois have recently discussed legislation that would provide a single-payer system, and others have previously discussed the issue.
 
Here is the problem though. If the government is financing the healthcare, why should we pay for the middle man in insurance companies to do the job?

This might be something we end up going to because people would not want to destroy the insurance industry and send all those workers into unemployment and I get that.

At the same time it seems inefficient to pay a middle man like that.
 
Here is the problem though. If the government is financing the healthcare, why should we pay for the middle man in insurance companies to do the job?

This might be something we end up going to because people would not want to destroy the insurance industry and send all those workers into unemployment and I get that.

At the same time it seems inefficient to pay a middle man like that.

I don't know the effect on insurance cos. but the Aetna guy doesn't seem alarmed. Kliff said this about Bertolini..."Kliff said that based on his comments, Bertolini did not support a total government-run single-payer system but could be open to a private-public system used in some nations."

Politicians from both sides are taking or have taken serious flack over this issue and it seems to me both sides would welcome a solution. The consumer damn sure would. Since some heavies on both sides are open to discussion, it's a good sign. (even Trump)
 
Three things:
1. If your going to extend the social safety net to include health insurance, you need to finance the majority of this expansion through the same mechanism we use to support old age/disability/poverty insurance; a payroll tax. If I recall the numbers correctly, withholding would need to be around 4% for employees & 8% for employers (raising the current withholding to around 11.5% and self-employment tax to around 27%)
2. I believe even if we move to a single payer for health insurance, we would be better off if we maintain competition in delivery. A government-run delivery system is not likely to drive innovation to compete for customers.
3. Federal Income tax should no longer be collected up to the earning limit for the social safety net taxes lifted above. Everyone pays the flat tax listed above to the earnings limit but no Federal income tax. Federal Income tax would then kick in for HROT members.
 
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I don't know the effect on insurance cos. but the Aetna guy doesn't seem alarmed. Kliff said this about Bertolini..."Kliff said that based on his comments, Bertolini did not support a total government-run single-payer system but could be open to a private-public system used in some nations."

Politicians from both sides are taking or have taken serious flack over this issue and it seems to me both sides would welcome a solution. The consumer damn sure would. Since some heavies on both sides are open to discussion, it's a good sign. (even Trump)

For private insurance companies a solution where the government contracts out insuring the entire nation to them would be the best solution ever devised. It would mean a huge increase in their business. So to me it's not much of a surprise that an insurance company exec would want that solution.

The problem for me is that while I like the universal healthcare implications of it, it also seems like the American public would be paying a decent amount of money for a middle man to run the whole system. And I don't see the substantial benefit that keeping the private insurance companies around would give to the American people. I don't see an insurance company as being any more caring or responsive to our needs then the government. Plus everyone combined in a government plan would mean the government would have greater negotiating power and the system would be more simple since one would not have to worry about what doctors are "in network" One could just simply see the local doctor of their choosing or when going to a hospital is necessary they could simply go to the nearest hospital and not worry about if that hospital is in an insurance company's network.

The network thing is bothersome to me because when my wife gave birth to all 3 of our children we had to drive 40 minutes to a specific hospital for this purpose. There was another hospital, much closer about 20 minutes away but it was out of network. And though we're happy with our experiences at the hospital we had our children at, it seems altogether silly that we could not use the nearer hospital.
 
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Three things:
1. If your going to extend the social safety net to include health insurance, you need to finance the majority of this expansion through the same mechanism we use to support old age/disability/poverty insurance; a payroll tax. If I recall the numbers correctly, withholding would need to be around 4% for employees & 8% for employers (raising the current withholding to around 11.5% and self-employment tax to around 27%)
2. I believe even if we move to a single payer for health insurance, we would be better off if we maintain competition in delivery. A government-run delivery system is not likely to drive innovation to compete for customers.
3. Federal Income tax should no longer be collected up to the earning limit for the social safety net taxes lifted above. Everyone pays the flat tax listed above to the earnings limit but no Federal income tax. Federal Income tax would then kick in for HROT members.

Excellent post. When you consider that by having a single payer system, you would remove the burden of health insurance costs from the employer and employee that they are already paying. This isn't all new money.
 
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Here is the problem though. If the government is financing the healthcare, why should we pay for the middle man in insurance companies to do the job?

This might be something we end up going to because people would not want to destroy the insurance industry and send all those workers into unemployment and I get that.

At the same time it seems inefficient to pay a middle man like that.

Agreed. Makes no sense whatsoever for the insurance companies (or hospitals for that matter) to be making profits on peoples' health care coverage.
 
That's coming sooner than you may guess with diagnosis algorithms and robotic surgeons.

You may be right.

How about we do this. Let's just let the government take over everything. We will have a central committee that decides what you will do and how much we get paid for it.

Good lord, the last thing we need is the government running healthcare. We have seen how that works with obamacare and Medicare and Medicaid.

How about we go back to choices, and let us decide what plan we want and what we want it to pay for.
 
You may be right.

How about we do this. Let's just let the government take over everything. We will have a central committee that decides what you will do and how much we get paid for it.

Good lord, the last thing we need is the government running healthcare. We have seen how that works with obamacare and Medicare and Medicaid.

How about we go back to choices, and let us decide what plan we want and what we want it to pay for.
I'm sold. Medicare is the best system in the world. Extend it to everyone. Government run healthcare works better. That has been proven true for decades all over the world. Your ideological beliefs are empirically false.
 
I'm sold. Medicare is the best system in the world. Extend it to everyone. Government run healthcare works better. That has been proven true for decades all over the world. Your ideological beliefs are empirically false.

So how long will Medicare funding last at current rate? So, how much have premiums increased since obamacare has been the law of the land? We were promised 2500 in savings. We were told you could keep your doctor and existing plan. Government run healthcare is so well run we were flat out lied to.
 
So how long will Medicare funding last at current rate? So, how much have premiums increased since obamacare has been the law of the land? We were promised 2500 in savings. We were told you could keep your doctor and existing plan. Government run healthcare is so well run we were flat out lied to.
Forever as soon as we dump all our health insurance funds into the system. How much were premiums going up before the ACA? How much did they slow? The ACA did save you money.
 
Eliminate private insurance and Medicare costs will have to skyrocket or physicians will bolt.....
 
Forever as soon as we dump all our health insurance funds into the system. How much were premiums going up before the ACA? How much did they slow? The ACA did save you money.

2026 and no it won't be forever. You can't cover everything for everyone, we can't afford it. No natural, address the specific. Where is the 2500 I was promised? That is what we were told.

How about just admitting the bill was junk and we had to be lied to in order to get it passed.

The thing is collapsing.
 
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2026 and no it won't be forever. You can't cover everything for everyone, we can't afford it. No natural, address the specific. Where is the 2500 I was promised? That is what we were told.

How about just admitting the bill was junk and we had to be lied to in order to get it passed.

The thing is collapsing.
I admitted that years ago. We are discussing Medicare for all here now. Try to keep on point. Medicare will be solvent forever if we dump the insurance money into the program. It will run a surplus allowing for higher reimbursement rates too. It is a near flawless solution you should support.
 
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Forever as soon as we dump all our health insurance funds into the system. How much were premiums going up before the ACA? How much did they slow? The ACA did save you money.

Exactly.

I worked for a company from 2002 to 2012 and managed the benefits during that tenure. Insurance rates went up double digits every year. Over 30% each of the first three years, over 20% the next four and low teens during the remainder. Anyone that thinks rate increases are solely a result of Obamacare has their head firmly implanted up their ass.
 
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I admitted that years ago. We are discussing Medicare for all here now. Try to keep on point. Medicare will be solvent forever if we dump the insurance money into the program. It will run a surplus allowing for higher reimbursement rates too. It is a near flawless solution you should support.

No, it is an important point. No it won't, there are still administration costs and if you look at government benefits that employees have over the private sector it may actually be more.

So, you admit the government flat out lied to us to get something passed, and now you want to give the liars even more power over our health insurance. That is really priceless.
 
Medicare will be solvent forever if we dump the insurance money into the program. It will run a surplus allowing for higher reimbursement rates too.

Won't be enough,... You can't expect current Medicare contributions + current private insurance contributions to suddenly be able to provide more coverage than we currently experience. If you want to expand coverage, you will have to expand contributions....
 
No, it is an important point. No it won't, there are still administration costs and if you look at government benefits that employees have over the private sector it may actually be more.

So, you admit the government flat out lied to us to get something passed, and now you want to give the liars even more power over our health insurance. That is really priceless.
You don't know this topic well enough to discuss this. The administrative costs are a fraction under Medicare. It's a primary reason the plan is cheaper. Your ideological emotional appeals carry zero weight.
 
Exactly.

I worked for a company from 2002 to 2012 and managed the benefits during that tenure. Insurance rates went up double digits every year. Over 30% each of the first three years, over 20% the next four and low teens during the remainder. Anyone that thinks rate increases are solely a result of Obamacare has their head firmly implanted up their ass.

Where has anyone said that? We were told, basically lied to, that we would save 2500 bucks and we could keep our doctors and plans if we wanted. Flat out lied to. Now, some of you want to turn over our healthcare to these same liars. Blows me away.
 
Won't be enough,... You can't expect current Medicare contributions + current private insurance contributions to suddenly be able to provide more coverage than we currently experience. If you want to expand coverage, you will have to expand contributions....
Sorry, you are wrong. We save 20% in admin costs alone. We know this plan works because it's been tried dozens of times and always works for less. You don't know what you are talking about.
 
Medicare "appears" cheaper because it is heavily subsidized by private insurance. Eliminate private health insurance and the true cost of Medicare will become immediately apparent.....
 
You don't know this topic well enough to discuss this. The administrative costs are a fraction under Medicare. It's a primary reason the plan is cheaper. Your ideological emotional appeals carry zero weight.


I know the topic plenty well, address the issue. Why do you want to turn over your healthcare to the ones who lied, which you admit, in the first place?
 
Sorry, you are wrong. We save 20% in admin costs alone. We know this plan works because it's been tried dozens of times and always works for less. You don't know what you are talking about.

Sorry you are wrong, and WAY to trusting of government.
 
I know the topic plenty well, address the issue. Why do you want to turn over your healthcare to the ones who lied, which you admit, in the first place?
Empirical evidence it provides the best results. Take your feelings out of this conversation. Every time you make an ideological political point and ignore the facts you prove I'm correct to dismiss your gravitas.
 
Where has anyone said that? We were told, basically lied to, that we would save 2500 bucks and we could keep our doctors and plans if we wanted. Flat out lied to. Now, some of you want to turn over our healthcare to these same liars. Blows me away.

I'm not advocating turning our healthcare over to anyone. I want a system that both parties work through where everyone has skin in the game. No system is going to be perfect and for either party to act like they have the only plan that will work is unadulterated bullshit. To end up with the best outcome, we will all still need to experience a little pain too. I have no problem with that.
 
Sorry, you are wrong. We save 20% in admin costs alone. We know this plan works because it's been tried dozens of times and always works for less. You don't know what you are talking about.

But the overall cost of insurance....nevermind, not getting into it.

I think we should move to single payer where the govt covers 70% of our costs and the individual overs the remaining 30%...just like the Aussies.

After critics noted that Australia has a universal healthcare system in which the government pays roughly 70% of all costs
 
Another capitulation to my facts. You are unable to control your feelings and think.

You have totally avoided the point, and you won't answer it. Has nothing to do with emotions. You have not provided one piece of evidence, you simply say it will save 20 percent and that is not true.

You admit we were lied to but you want to turn over your healthcare to those same liars, is that not true?

It's just like the bs we were fed about people saying companies cancelled them when they got sick. Another lie.
 
But the overall cost of insurance....nevermind, not getting into it.

I think we should move to single payer where the govt covers 70% of our costs and the individual overs the remaining 30%...just like the Aussies.

After critics noted that Australia has a universal healthcare system in which the government pays roughly 70% of all costs
And how much does that system cost? Less than ours right? Significantly less. Which shows there are enormous savings to be realized if we adopted a system like that. Note that that system is very similar to Medicare for all.
 
Empirical evidence it provides the best results. Take your feelings out of this conversation. Every time you make an ideological political point and ignore the facts you prove I'm correct to dismiss your gravitas.

Oh, Empirical Evidence...I liked the movie Old School as well.

 
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You have totally avoided the point, and you won't answer it. Has nothing to do with emotions. You have not provided one piece of evidence, you simply say it will save 20 percent and that is not true.

You admit we were lied to but you want to turn over your healthcare to those same liars, is that not true?

It's just like the bs we were fed about people saying companies cancelled them when they got sick. Another lie.
I won't entertain your tantrums. That's all you have.
 
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And how much does that system cost? Less than ours right? Significantly less. Which shows there are enormous savings to be realized if we adopted a system like that. Note that that system is very similar to Medicare for all.

Hey man, I am for it. Hell I have been saying I am for this approach for some time, but you guys don't like to listen. Basic and backstop care for those who cannot either afford or qualify for a supplemental Premium level private insurance plan should be taken via medicare...it is the most logical solution and has been for some time. Just wish Obama could have seen it bc Obamacare would be a lot better off now with this sort of public option.
 
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