91–100 of 407 posts
The net savings would be $450B, but the total cost would still be in the 10s of trillions of dollars (Edit: 30-50 over 10 years), bigger than all of our federal spending combined. It's one thing to have as an objective, and another as a plan for getting there. The proposal they cite would make federal healthcare expenditures 69%(!!!) of the GDP (Edit: total federal expenditures). It's simply not realistic to convert…
This excerpt makes it glaringly obvious that no economists were consulted when writing this paper. Checking the list of authors confirms this. While they may be experts in public health, they're making one of the most elementary errors in Econ 101. That is they're assuming that a private expenditure (employer provided healthcare insurance) can be transformed into a public tax with no loss of efficiency.
Deadweight loss[1] is the very first consideration in tax policy analysis. The reason it exists is very simple. Private actors have an incentive to minimize taxes in a way they do not with private expenditures. If you cut your company's health insurance plan, your employees will be unhappy and you'll either lose workers or have to raise compensation in other forms. If you restructure your company to avoid payroll taxes, your employees still enjoy the same access to single-payer healthcare.
Many M4A advocates try to hand-wave away this problem. It's the equivalent of declaring "Then a miracle occurs". In this case the authors assume that the current employer-paid premiums are equivalent to replacing with a uniform payroll tax matching this aggregate. While 12.29% is the average across the entire economy, there's still wide variance between employers. Approximately half of employers are currently paying less than this. A significant proportion are paying substantially less than this.
If the current system was replaced with a uniform payroll tax, the cost of labor for employers falling into this category will rise. In response that means those employers will lower their demand for labor, which results in either both economy-wide reductions in employment, wages and ultimately investment and GDP. Those results will mean that not only will the hypothetical new payroll tax not raise the revenue the authors are projecting, but current pre-existing taxes, like income and capital gains, will also see revenue shortfalls relative to baseline.
In the study, nearly all the computed savings comes from two sources. 1. Decrease in pharmaceutical costs as a result of better bargaining power. 2. Decrease in administrative overhead, calculated by extrapolating the overhead in medicare to the entire US healthcare economy. I don't have an informed opinion on either of these estimates, but my intuition is that #1 seems reasonable while #2 seems unlikely. The justifi…
Earlier quoted context omitted.
>Many procedures are made unavailable due to being considered cost effective by The Single Payer whether the insurance is coming from a single payer or a private company, access to health care does not mean unrestricted access to any medical procedure you want. Private insurers also deny treatments that aren't considered to be cost effective.
That's what I've never understood about the arguments against single payer: >You can't pick your own doctor I already can't. If they're in network, I'm good, but if they're out of network - like my doctor was - then I have to find a new one. >You can't pick your treatments My spouse was denied medication by an insurance company because it was too new. So. >You don't get to have all the healthcare you want I already h…
The one I've heard the most lately is that "people like their existing insurance companies", which I think is an almost absurd thing to say on its face. But its probably just a way to say "people don't like change" that doesn't get insurance companies or "people" salty about it.
As Churchill said... “You can always count on the Americans to do the right thing. After they have tried everything else.”
This is a terrible proxy.
The VA doesn't really negotiate, the discounts are mandatory to do business with the VA, which is an incredibly small slice of the entire US healthcare system.
When they do negotiate, it's because they promise to exclude other drugs. As a result, there are many drugs you can't get at the VA.
Earlier quoted context omitted.
That's why the Medicare for all will still be funded, in part, through a business tax. The difference being you've removed the for-profit middlemen, so the healthcare costs are less for businesses than the privatized hybrid version we have now.
Exactly the health care costs are less for businesses. But that's not coming through efficiencies but largely through the US government picking up the tab for it. Which is completely fine because it's what happens elsewhere in the world. But there is no discussion around the impacts to budgets and taxpayers which is the challenge the faced Australia and UK for example.
I'm paying nearly 20k (parents+child) on insurance I don't have time to use (and luckily no serious need) and once my son went to see his pediatrician and our 'private' insurance company (that i'm not going to name) sent us bill of $500, for a check-up. We disputed the charge with the insurance and they agreed to wave the payment next month. Next month comes and guess what? The same letter comes in mail. We disputed…
So yes, much of your costs are for possible emergencies and especially as you get older, your costs increase.
Earlier quoted context omitted.
> The government has zero ability to control its expenditure, because the electorate vote themselves benefits. Could you give me some examples of this? Living in a nation with universal healthcare, I've never seen this.
What else would you call students voting for loan forgiveness? Point blank the candidate is effectively saying, "we will give you $xx,xxx" in the form of loan forgiveness. It is the same for healthcare. This is a literal voting for benefits; and, this creates perverse incentives for the electorate to vote for whomever will "pay them" the most for their vote. Candidates are simply buying votes by offering free stuff w…
One candidate says that they're going to reorganize the local government so that our roads will be fixed. With your argument, that candidate is trying to bribe voters in order to get into office and the voters are simply voting for benefits.
I am sure, on paper, it is a brilliant plan. Unfortunately, reality and human behavior almost never follow the plan. Is waste, fraud, and abuse taken into account at all in this study? What about the inevitable changes to consumers' motivation, behavior, and decision making around healthcare? It will change drastically as the cost of their care is even further removed from them than it is now. People who have a procl…
Let's take smoking as an example. You think there are people out there who will smoke, knowing that it causes lung cancer, because they figure government will pick up the tab for the chemo? Bizarre, but ok, if so, why doesn't having insurance give them the same incentive?
Besides, if the prospect of lung cancer was enough to scare everyone off tobacco there would be no one smoking still. People are not always rational and yes I can see someone rationalizing their decision to smoke, in part, on the fact that if they do get sick they won't have to worry about paying for it. Or from the other direction if you know doing something could make you sick the prospect of simultaneous health and financial problems will be enough to push a larger portion of the public into making the healthy decision.