I’d argue that a for-profit system is part of the reason we treat health in this manner - or maybe that’s what you’re aruging here? We focus on treating instead of wellness before hand, primarily because for-profit insurance companies find that to be more profitable.
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That’s the opposite of true. It helps increase costs because the patient only sees what they pay and insurance companies pay the rest. This means that a doctor’s office or pharmaceutical company can jack up the price of whatever as long as the patient is willing to bear the copay cost.
For instance, I was prescribed a drug for a while that cost me $60 a month in copay. I paid it. When I lost my insurance and went to see how much it’d cost out of pocket, it was $3000. In Mexico it costs $30 a month no insurance. In Canada it costs $90 a month straight from the manufacturer.
Copays don’t do anything to reduce costs.
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[quote=“zachstronaut, post:5, topic:139990”]
Some questions!
- How do we balance the Freedom of Choice section with the need to reduce costs, for example by having folks with very common ailments see an RN or Nurse Practitioner or whatever instead of an MD?
That’s a refinement that could perhaps be added…but maybe we need to start with a “simple” single payer siystem.
- Why do we need “Medical Cards”? Do we not already have a system to establish residency?
Medical cards establish a private confidential medical record
- Can all enrollment be automatic, not just for newly born residents? Why would we need an enrollment system? Do we not already have another means to establish residency?
See answer to 2, above
- Additional private insurance is still allowed… can some folks from civilized countries tell me whether that’s a thing and why?
As someone else in this thread noted, Medicare may not cover everything: “cosmetic” treatments, extra dental treatments (crowns, root canals), acupuncture or other Chinese medicine treatments, massage, some kinds of psychotherapy…and some medical providers do not accept Medicare due to paperwork requirements or what they consider to be low payout.
- States are allowed to provide extra benefits above and beyond… wait what? The federal coverage is supposedly “comprehensive” so what extra is there to provide?!
See answer to 4 above.
- The law forbids copayments. A nominal copayment system seems like an effective way to control costs since it discourages unnecessary office visits, but there’s no such thing as nominal if you live in poverty. So I guess I’d want to to be a product of income, at which point maybe it becomes too complicated to be worth it? Also, perhaps unnecessary office visits are not really a significant source of extra costs in the medical system.
I don’t know what I think about this one. I am low-income & prefer not to have a co-pay.
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I am an older person & very thankful for Medicare despite the hassles. I cannot imagine life without it.
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One of the biggest benefits of single payer? If I am sick, I never have to stress about finding a doctor “in network” or worry that one who isn’t will glance at my chart and add several thousand dollars to my bill that insurance won’t cover. I don’t have to worry that the ambulance will take me to the wrong hospital and bankrupt me. I don’t get suddenly told “hey, new member(s) of your plan, new deductible limit!” if I give birth. I don’t have to phone and negotiate with the hospital to cut a deal for payment all while I or a loved one is sick.
I go to the doctor, they check me out, etc. and I don’t get a bill in the mail months later for more than my annual salary. The longest I have had to wait to see my family doctor was three weeks – because he’d gone on vacation.
I wouldn’t even be alive under the US system, because my parents couldn’t have afforded to have me. So, yeah, I am kind of a fan of single payer. I just wish ours covered more – vision and dental aren’t included where I am, and including them is something that I definitely support, given that the science shows both are highly beneficial to general health.
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i’ve been curious what happens to the va with medicare for all. im assuming there are still specialists that are needed? but, maybe some of the issues with underserved areas and overutilization will go away? ( cause vets will be able to use regular hospitals? )
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Yeah, my mom and I used to watch Grandpa Munster’s Sci-Fi show on Saturdays. It took me years to remember what this scene was from. Same with the quote “He and She will provide.”
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I think this is more dependent on which state you live in. When my oldest were born and we fell on hard times we were all covered by Medicare and it covered absolutely everything including dental and vision. No copay and every doctor we went to accepted it. Dentists were harder to find, but there were still a half dozen or so within a short drive. This is in New York, so ymmv if you live in a less generous state.
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Hm… interesting… Now I kind of wonder if part of the push back against a medicare for all comes from some in the VA (or in the pentagon more generally) who don’t want to see a privilege of the military class eroded? 
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according to this - a pro single payer advocacy site i found googling around - least, 23 million vets aren’t covered for various reasons. (only about 9 million are?)
so maybe if you “support the troops” medicare for all should be part of that support…
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Indeed! It’s more of a illusion of a privilege for many troops rather than a reality. None the less, the perception that it’s a privilege (that I’m guess the people at the top of the military echelon have full access to) of the military class might drive resistance to medicare for all. If going into the service, someone thinks they’ll get that privilege, it certainly would be part of the calculation to volunteer…
Agreed!
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It’s time. I’m not trucking with “affordable.” Affordable means means-testing and doing mounds of paperwork just to get to “go.”
We already have a reliable system for means-testing, it’s called taxes. Let’s go. And let’s not get hung-up on minutiae. And don’t fall for lies.
I promise you that the for-profit health industry is going to start spreading them and start letting you get hung up on some real bullshit things that are easily misconstrued.
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That would be Medicaid, which is a completely different kettle of sardines.
Currently, in tue US: Medicare = covers old people over age 65, and some disabled people. Pays 80% of the typical fee, covers doctor and hospital visits and tests, does not cover vision, dental, or a host of other non- “provided by a medical doctor” types of care. Some doctors accept the payment from medicare as payment in full, others require you to pony up the difference. Hence private “medigap” insurance plans. Patients do not have to fill out any paperwork, what bureaucracy exists is hidden from you.
Medicaid = covers only the extremely poor, pays 100% of the fee, covers all sorts of things in addition to doctor/hospital fees. Is part of the daunting welfare bureaucracy.
Eta - fix horrid typo
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There’s a good reason that there is a saying “the devil is in the details”.
I would say let’s not fall for “pass it to find out what’s in it” again.
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Who is saying pass it without reading it? @reactionabe is noting that we have a means-tested way of paying for programs like this, and it’s called taxation. Taxation won us a major war against fascism, built our public highway system, a public education system that for a while was quite excellent, and helped to create a period of pretty well shared period of abundance in the postwar era. We know how to pay for stuff that we want to do together as a country, because we’ve done it before, and other countries are doing it right now. There isn’t a reason to discuss that part because we know how to pay for public projects.
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I agree, we shouldn’t fall for GOP memes about how the publicly available bill wasn’t publicly available like with the ACA.
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Hell, I want Medicaid-for-all: I think that’s the actual goal, “Medicare” is just for optics (Seniors “earned” their Medicare, Medicaid is bad because it’s for lazy blah people), but Medicaid is amazing. My wife (at the time girlfriend) was on it briefly, and I couldn’t buy, much less afford, comparable health insurance. “Oh, but the cost to the taxpayer!”
But the important thing to remember about the Medicaid expansion was that it was a last minute fix to keep the price tag down.
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Yes, you’re right. I always confuse the two. Well, whatever the system is it should have comprehensive coverage for all citizens regardless of age. Vision and Dental, too as they aren’t exactly “luxury” services and contribute just as much to one’s overall state of health as primary care.
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By “extremely poor” we’re talking about very sizable percentages of people in most States, especially after the expansion.
As to “daunting bureaucracy”, on the “I need to go to the doctor” side it was an order of magnitude smaller than the bureaucracy of a private health insurance system.
The worst part about the bureaucracy was the means testing, and even with the huge overhead of punitive means testing, it still delivers healthcare at a fraction of the cost of private plans.
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