251–260 of 468 posts
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Several of those countries implement universal coverage using a private insurance model.
In almost all European countries, its provided by the government and funded by taxation. My point stands.
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assuming you're asking in good faith, the answer is pretty simple. A larger population has more leverage, and if all of the citizens bargain as one bloc (i.e., if the government does so on their behalf), it drives the market. Note that a tremendous chunk of the market needs to be involved for this to have maximum effect -- if a physician can "opt out" of Medicare/MediCal and make more money, they will, by and large.…
> In the US there are a great many physicians who simply won't accept Medicare rates (they're viewed as too low by most) Right there is the big problem, though: Medicare reimbursement rates are already below sustainable levels for providers, which actually results in providers charging private insurers for the difference. If Medicare were expanded to everyone, either Medicare would have to increase its reimbursement…
But as long as healthcare providers can find someone else to overcharge then they'll do that rather than accepting Medicare patients.
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It seems like most of the complaints about healthcare now relate to unpredictable costs and complexity though. I'm not sure the simplicity and stress-reduction of a single-payer system really are appreciated. I'm Canadian, and our system is fair from perfect. That said, it's hard for me to comprehend the stories I regularly read about people's experiences in the American system, trying to decide on plans, sacrificing…
As a Canadian as well, I appreciate you being up front about the drawbacks of our system as well. I've heard so many American's say "oh, the Canadian system is so much better". Is it better in coverage? Obviously! However, when I ask if they'd be ok waiting over a year for joint replacement surgery, they get a weird look on their face. Or, if they have cancer, they aren't going to get to go to the best cancer center…
> waiting over a year for joint replacement surgery
1) Remember that many Americans have no access to healthcare outside of emergency rooms; they wait forever. I know plenty, including connected people, who wait months for simple appointments. A year before surgery wouldn't surprise me at all.
> if they have cancer, they aren't going to get to go to the best cancer center in Canada, you go to your local hospital.
2) Again, many Americans wait forever. Few others go to the best treatment centers in the nation - how much capacity do those places have, and who is filling up the local facilities?
> if you want the latest and greatest cancer treatment? Well, you'll need to pay for that yourself since the gov't hasn't yet approved it for reimbursement.
3) Again, some Americans get no funding. Most others are limited to what their insurance companies cover and often have the same problems.
so should the government force those people to spend their earned income on healthcare for others? Absolutely not. Pretty much any question that starts with "should the government force ..." can be answered "no". You earned your income, it's yours and it should be up to you how to spend it. Using force / aggression (aka the government forcing you to do something) is a violation of your most fundamental rights, and st…
If you have have 5 beds, and 10 people that need to use a bed every day, there is no pure finance management solution to solve it.
If you have insurance-based system like in US, only people who can afford insurance will be able to use the beds. Rest will be priced-out.
If you have single-payer system like in my country of origin (and what a lot of people in America would want), people will be queued and/or to some extent squeezed to fit on what's available. It often leads to corruption, when people pay extra to cut the line. Or there are some officially approved way to pay your way to get your bed fast and without overcrowding.
The reality is of course a bit more complicated, but the point is: the real solution is to either have more beds, or to have less people who need to use them. Why can't more beds be built and operated cheaply? Why there is so many people needing them?
I simultaneously believe in universal coverage as a moral imperative, but also the efficiency of markets over government AND basic income as a necessity as automation displaces millions of workers. So, why not combine concepts - start off with basic income that has to be spent on health care insurance. Start with enough for coverage against major issues, but people can spend more for more coverage. Universal coverage…
I'm pretty confident that if you get rid of individual mandates while not disqualifying sick people or enforcing benefit caps, premiums will skyrocket. I'm not sure there's really a middle ground here, it's just unavoidable actuary math. So if it is, as you say, a moral imperative, what are your choices? Maybe the EBI will need to be ridiculously high to actually provide the coverage you agree is a moral imperative t…
Benefit caps are a really tricky issue. As a society, are we willing to spend a million dollars to extend life for a week? Probably not. On the other hand, do you cut off a cancer patient after a million? Probably not. But there has to be a rational way to balance this without people freaking out over 'death-panels'.
I agree, universal coverage means vastly more money spent. Therefore, coverage for major issues is the baseline amount, not the Obamacare standards where people generally have way more insurance than they would choose.
The closest proposal I've seen is tax credits for this.
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[2] is about CalPERS, which is separate from the budget of the State. There may be a current budget shortfall, but CalPERS is fine (it is the largest non-country pension fund in the world; and comes in the top 10 when listed among countries). [3] mentions that tax revenues will fall because of the end of temporary tax increases; those increases are likely to be renewed. Categorizing these as 'severe budget issues' is…
Uhh, no thanks. I'd rather be able to decide for myself what healthcare I buy, instead of being forced into a substandard single payer system. Ok, fine, create a public option. But don't force me to buy it. Let me buy my own healthcare.
Would you be OK with a requirement that you do, in fact, spend the refund on health insurance?
Otherwise I see a problem where struggling people opt out of the care, to get cash to pay for other emergencies, and then the state ends up footing emergency room bills anyway, and premiums are out of whack due to decreased enrollment by healthy people.
Also, what happens if your private care falls short and you show up one day at the State emergency room? Do we refuse you care because you opted out? Emergency rooms need to give care to everyone, that's the point it's an emergency and you don't want to have your care waiting on your paperwork being out of order in an emergency.
If we can reserve part of your refund to cover such situations, I'm ok with it!
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Even easier if people could just let others take care of _every_ whim. If there was a guaranteed income there wouldn't even be a need for entrepreneurship!
the interesting thing to me is why didn't CA make these moves under Obama if they thought they had such a better plan for healthcare... either way it's a win for DT
Fortunately the world moves on independent of his desires.