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Single-payer healthcare would save $450B and 68k lives a year: study

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301–310 of 407 posts

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#301
post #149

Earlier quoted context omitted.

This is where I think political leaders (Democrat or Republican) could do really well. It's not just making sure people are covered. It's the existential dread of dealing with opaque, unpredictable, and incomprehensible bureaucracy that can make life-and-death decisions or drop financially crippling bills in your lap, even if you have good insurance . The American health care system isn't just bad for the poor. It's…

> We just can't deal with it, because we are exposed directly to unnecessary complexity. I'd argue though that those best adept at handling the complexity are actually winning in this model. If you are reasonably healthy already and can navigate HDHP/HSA rules, you can have a much higher take-home income + savings than in other countries with government run healthcare systems.

You are missing the point. It is not about being healthy. You are always worried about the "what if I have to go see a doctor" situation in America because you don't know what it will cost and you definitely don't know what kind of issues you will have to fight through with incorrect claims, incorrect bills and what not. If someone can address that here in US, I am willing to keep the current system as is.

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#302
post #62

Earlier quoted context omitted.

If you have a reasonably middle-class income, the plans are prohibitively expensive and unbelievably shitty. I'm only anecdotal, but by comparison, prior the ACA, my insurance for a family of 3 was $300/month with a $2500/year deductible. That $300/$5000 plan was considered predatory and high deductible. The first plan offered to me under the ACA was something like $700/month with an $8000 deductible. Plans this year…

Interesting I didn't know it had those issues

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Re: Single-payer healthcare would save $450B and 68k lives a year: study

#303
post #173
post #61

Earlier quoted context omitted.

Real question, not snarky: Why is this sort of downsizing always wrong for white-collar workers when blue-collar workers have been dealing with it for decades?

There’s a huge difference between downsizing caused by economic forces of the private sector and downsizing caused by outright elimination of an industry by elected officials.

Healthcare (as some other sectors) is full of inefficiencies and removing or, at least, reducing them cannot be seriously labeled as "elimination of an industry". I don't see how job market restructuring in healthcare industry due to proposed transition to the single payer model is different in its essence from potential significant job market restructuring across various industry sectors due to automation trend.

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#304
post #187
post #115

Earlier quoted context omitted.

The reason I disagree with this is because our healthcare system is largely built upon treating someone after they have an apparent issue, instead of preventing the issue. It seems very difficult for a healthcare system to stop someone from becoming obese to begin with, or stop someone from abusing drugs that is intent on it and not seeing anyone intentionally, or stop problems like depression by their root cause ins…

Actually it happens. You go to the doctor with some side effect, like headaches or high blood pressure and they nudge you to go to the dietist. Of course you can refuse, but there are a lot of kind and caring professionals and you know it won't cost you money, so it works sometimes.

Right, but the keyword there is 'nudge'.

If you are already having headaches and high blood pressure due to your diet, your diet should have been modified long ago. Similarly when people have cardiovascular issues and atherosclerosis, the time to change things was likely decades ago, not after they've already damaged their body so much. Sometimes these 'nudges' help patients, but getting someone to significantly alter their life is very hard.

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#305
post #149

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…

This is where I think political leaders (Democrat or Republican) could do really well. It's not just making sure people are covered. It's the existential dread of dealing with opaque, unpredictable, and incomprehensible bureaucracy that can make life-and-death decisions or drop financially crippling bills in your lap, even if you have good insurance . The American health care system isn't just bad for the poor. It's…

My favorite story to tell (favorite in a horrible way) about these kind of issues is this: After an accident ~15 years ago, I had an open wound that wouldn't close because it was infected with MRSA which had lodged itself in the hardware that was screwed to my tibia. I was wearing a wound vac--a device that was attached to the open wound and maintained a constant suction to pull out any bad stuff. It was there to keep the infection from spreading long enough for the bone to heal so they could remove the hardware. I had a weekly doctors appointment at the local hospital check on the condition of the wound and change the dressing on the vac.

I was very careful. The doctor was in network, the hospital was in network, and my copay was, I believe, $30 for each visit, covered under my insurance. One day I showed up for my appointment, they led me to a room where I waited 10 minutes. Then the doctor came in, and it wasn't the guy I had been seeing for the last three months. He told me my doctor had taken ill and he was covering the appointments. He asked me how I was doing, and had the nurse redo the dressing on the wound vac. Then we were done.

A month later I received a bill from this doctor for $1900 because he was out-of-network, and while my insurance covered out of network at 80%, they covered it at 80% of the in-network rate. The doctor billed out of network patients at about twice the negotiated in-network rate (a fairly common occurrence), so the 80% coverage was actually 40% coverage, and I owed the other 60% which came to about $1900 for 5 minutes of work (the nurse who changed the dressing worked for the hospital so her work and materials were covered in network.) And the kicker was that I didn't know a different doctor was going to be attending me until he walked in the door.

If you think that maybe your "max out of pocket" will save you, it won't. If the insurance lists a "out of network max out of pocket" it only covers expenses at a negotiated in network rate. Any amount your out-of-network doctor bills that is over the insurance company's in network rate is effectively unlimited. Despite having a $2500 in network max, ad a $5000 out of network max, and a very good health plan. I left that accident with about $35k in medical debt.

(An interesting side note, when it came time to remove the hardware, I went back to the same hospital/trauma center and doctor who had installed it--though a different hospital from above. A day before the surgery I went to the hospital for the pre-op stuff. At the end of the process, the hospital admin met with me to take my payment. I was expecting a $30 copay or similar, but I found out that while the hospital was in network six months before, they had dropped their contract with my insurance company a month prior and the pre-op was going to cost me $800. So of course I cancelled the surgery, but I was still on the hook for the pre-op work. Today every time I visit a medical professional of any kind, no matter how many times I've visited them before, I ask about in network coverage.)

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#306

Earlier quoted context omitted.

i mean, i'm within coverage of brazil's public health care. i can go to any public hospital right now and get whatever care i need. no extra payment required. (you can read more here https://en.wikipedia.org/wiki/Sistema_%C3%9Anico_de_Sa%C3%BA... ) but i also pay for private health care -- because it's... well, better. and fortunately, i can afford it. so i can go to a private hospital and also get whatever procedure…

Pretty sure thus is the way everywhere here in Europe too, you still pay the huge compulsory insurance but no one forbids private insurance or private out of the pocket. In fact many private places also offer things covered by national insurance if they agree to prices set by the gov.

that's basically my question: can you, within bernie's proposals, do that or not or not?

if not, i think his proposal is not that great.

if you can keep your private health insurance? well, that is a great plan and i would 100% agree with it.

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#307
post #167
post #119

Earlier quoted context omitted.

$6000/year sounds very low for healthcare in the U.S. When you say "I pay" are you really only counting the employee contribution? For purposes of analyzing aggregate healthcare costs for a whole country, we ought to be using combined employee+employer costs (W2 DD) and not just the (usually small) employee portion highlighted by HR at benefits season.

Not op, but you got me curious so I checked my W-2. $8,800 for me and I think mine is top notch (2,600 is my max out of pocket per year limit)

fwiw mine is about $20k with a $5k oop max, for a family of 2 in California. This compares to a worst-case ACA cost of about $65k.

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#308

The answer is simple, vote for a candidate that campaigns on universal healthcare. That candidate may not be the politically purest one.

Isn't every Democrat supportive of universal healthcare? (Which at the minimum is just ACA + technical fixes on it) There are differences through whether it should be single-payer or not.

ACA is not universal healthcare. It only made things worse overall except the fact that people cannot get denied due to pre-existing conditions. Obama should have pushed for a public option with ACA at the time. In 2020, fuck that. We want to go straight to Universal healthcare, single payer. No middle ground. Only 1 democrat supports that so I am voting for him.

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#309
post #101
post #45

Earlier quoted context omitted.

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…

I know it's an edge case, but there was that kid in the UK with an easily fixable, but fatal, heart condition. Their health association refused to pay for it because no doctors in the UK knew how to perform the surgery, and they weren't willing to pay for them fly to the USA where there were specialists who could do the surgery. After they started a GoFundMe to pay for the surgery themselves, and there was a lot of p…

> I've also read a lot of stories from people in Canada and the UK saying that it's almost impossible to get same day medical care, even from a general practicioner. Like, they'll have to call as soon as they open, and hope they aren't already booked for the day.

It highly depends on the situation.

If you're trying to see your family doctor for something routine or non-urgent, yes, it can take a few weeks to get an appointment, as they tend to be booked up.

If you have a non-critical issue that needs to be taken care of sooner (eg, an ear infection), many practices run an "urgent care" or "after hours" clinic, and there are also dedicated offices (often co-located with a pharmacy) that do the same. I'm not sure how exactly these work, but they don't cost anything, and you can generally get in within minutes to hours, depending on your situation and how busy they are.

If you are in need of emergency care, you go to the ER (and/or call an ambulance), and get triaged. If you are having a heart attack, for example, you will get treatment immediately, but for lesser problems you can sometimes wait several hours. This is also the one case where the system can actually cost you money of-out-pocket, because if you're waiting that long you'll probably want to buy something to eat.

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#310

Earlier quoted context omitted.

> You already are? That's how health insurance works. I am not a defender of the insurance system. It blows. But single-payer is not the only other choice. I want a freer healthcare market where prices are known before consuming services. Real market competition could actually occur to bring down prices. For drugs, research and development for less profitable cases could be a very worthy target of government funding.…

Healthcare is not and cannot ever be a free market. You cannot have price transparency when a buyer may be unconscious at the time of "purchase". You cannot have price competition when buyers are frequently forced to immediately purchase a good or service if they don't want to die. Hospitals are chosen by proximity, not price. These are the consequences of being mortal human beings. If we were all immortal, and "heal…

> You cannot have price competition when buyers are frequently forced to immediately purchase a good or service if they don't want to die.

The number of instances where this dire case occurs is minimal compared to every other instance. Sure, when its life and death its not practical. Perhaps those sorts of situations is where single payer or insurance makes sense.

For humdrum things like physicals, wellness visits, cold and flu checks, vaccinations, routine labs and imaging, etc. a free market could work very well.

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