Possibly they needed a picture of a famous peddler of myths?
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That’s… not what happened.
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Not if the system is modeled on medicare for all…
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You just making stuff up about what I said probably means you need to actually go back and read through the information presented rather than replying with emotion. You might believe a lot of things about the US medical system, but you are wrong - the rest of the world has on average better healthcare outcomes on single-payer systems, and people like you have been sold a lie that the US has uniquely excellent medical care and that is the “advantage” to letting anyone who cannot pay for the care die or go bankrupt or both. The best that can be said as a comparison is that the United States has some very excellent doctors and hospitals, just like literally every other single industrialized country in the world. What we also have is a lower life expectancy, insanely more expensive healthcare costs for comparable results, and unregulated prescription prices for required meds that is getting worse and not better.
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Wait, you are saying you only pay for healthcare out of pocket? I highly doubt you would even be doing the bare minimum health check-ups under those circumstances since the insurance game is so rigged they get the “real” prices and people don’t.
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Dealt with in my reply to @MalevolentPixy above.
He says it was the best facility for his procedure, and was “capitalistic medicine”: treatment from a private hospital that will welcome any patient from any country so long as he or she has the cash. He glosses over the fact that Shouldice gets the majority of its funds from the public system and probably could not stay in business otherwise, and that any Ontario resident can get the same treatment free of charge.
As noted in the link I posted, the private nature of Shouldice may mean that it continues to use outdated methods that public hospitals have given up.
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Shifting the money from one to the other won’t work. Medical spending in the USA is $3.5 trillion (17.9% of GDP). Military spending is $0.61 trillion (3.1% of GDP). Medicare alone is $0.71 trillion (4.2% of GDP).
And that’s even if you ignore politics and defense needs to shift 100% of the money. You might make a argument to get down to 1% GDP military spending, but that by no means frees up enough money to provide even current Medicare.
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Without stalking to to confirm, can I assume you are an Australian resident? Because I want to clarify one thing that people miss. The total cost to you (very likely) wasn’t $0. The extra cost to you for the procedure was $0, but you paid in other ways. Can I ask how much you pay yearly (in whatever form) to the system that treats you?
I’m not knocking your system. It’s going to be cheaper than in the USA. But everyone seems to confuse single payer with “free.” There is a cost, a reasonable cost, and it’s beneficial to know what it is and how it’s paid. Can you tell us?
On the flip side, the care is different. Some is vastly better. Some is the same. Some is worse. There are peculiarities of what Americans expect from healthcare that drive up cost. We’ll need to adjust. It would be useful to know what those adjustments are? Both positive and negative.
BTW, I was going to blame end of life care for one of the big drivers of US spending, but was surprised to find this. Apparently that’s one area we are not so messed up in.
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2017.0174
In Texas, we already have those.
It’s not just rich Americans. It’s middle-class Americans going to Mexico for insulin and insurers paying for people to get procedures in other countries, including airfare and room & board.
ETA:
$1.7 trillion of that $3.5 trillion is the private health insurance industry. So that cuts it in half right off the bat.
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It’s even worse than that.
In the US, there are GPOs (Group Purchasing Organizations) that are paid by hospitals and clinics to negotiate with suppliers for everything from office chairs and garbage bags to pacemakers and surgical robots. These middlemen contract with a large number of hospitals to increase their leverage. So far, it sounds like a libertarian wet dream, right? Here’s the catch: they get paid by a percentage of the value of the purchased equipment. So it is opposite their best interest to save their “customers” money. But they need to make it look good, right? So they negotiate very high prices with “rebates” for volume. The GPO takes 3% of a larger number, the supplier sends a kickback to the largest volume hospitals, while smaller community hospitals within the system are screwed.
Yes, we’re talking about publicly-traded companies that looked at the Mafia’s business model and said, “Let’s apply that to Hospitals!”
The biggest of these GPOs is Premier. They are a $1.7B company with 33% margins (I’m not even sure how it’s that low, when they do so little), which makes them larger than many of the hospitals and suppliers they act as go-between for.
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How can we afford not to?
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I had no insurance, ACA passed and then the law said I had to have insurance. What did i miss?
I negotiate prices and shop arround just like with all major expenses in my life.
I can’t tell if you are trying to be funny or can’t do math. By law, the private health insurance industry must spend a minimum of 85% providing healthcare. Administration and profit are from the remaining 15%. Assuming that people are going to still need the healthcare than the 85% pays for and that none of the administration is needed means a maximum cut of 7.5% (not 50%) right off the bat.
Since insurance companies are averaging 3.1% profit, then the cut right off the bat could be as low as 1.6%.
No, it takes more than “just have the government pay for healthcare” to reduce costs.
Here’s why I roll my eyes at all the “we mustn’t do anything unless the plan is 100% perfect in every way” concern trollery:
But isn’t my damn job. Every other comparable country in the world manages to deliver superior health care at a far lower cost. That part is off the shelf. The transition is the hard part, but it doesn’t have to be hard for “me.” It doesn’t have to be expensive for “me.” Other people can take care of that shit. That’s what the wonks should work on, not how to make me have more skin in a game which already involves my literal skin.
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That’s their premiums revenue, not even counting copays, coinsurance, or the expenses they don’t cover.
ETA: Dammit, and having to argue this again and again makes me numb to some of the salient points. FFS, the $3.5T is SPENT by PEOPLE ALREADY. You’re playing 3-card Monty with health care expenditures. Everyone in the chain, from insurers to doctors to hospitals are getting paid, and many are for-profit. Even if there is ZERO improvement in efficiency, the money is already there. It’s already spent. What do you mean, how are we going to pay for it? We already do!
And that’s a big part of why healthcare is so expensive in the US. If you can only profit off of 15%, make the 85% as big as possible to grow the 15%. Perverse incentives lead to market distortion, film at 11.
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To put this meme in its proper context, and not what the right-wing echo chamber’s corporate taint-lickers have twisted it into:
Pelosi was responding to the absurd criticisms of the ACA that had absolutely zero basis in reality when she said that once the bill was passed, people would have the ability to see what was actually in it, as opposed to the “pull the plug on grandma”, “gubmint’s gonna take away your Medicare” fearmongering that Republicans had spent the previous 2 years fomenting. She knew exactly what was in it. So did Republicans. There was no secret hidden agenda that would only be revealed once the bill was passed; only the truth.
I forget if I posted this math in a previous thread, or if I’ve only ranted about it on Twitter, but here we go (with improved math either way, because I finally found the actual rate sheets):
Last year, I paid $4,820 for medical insurance. That’s 100% of my wife’s premium, plus 25% of my own. My employer covers the remaining 75% of my premium. All told, that’s roughly $6,250 for two people. Vision and dental insurance are about another $900. That doesn’t include the costs of medications, doctor’s visits, blood tests, or medical equipment (my CPAP costs about $800 per year to keep supplied), all of which comes out of pocket because of a better-than-most-plans-of-an-equivalent-cost $2,000 deductible.
Over the same period, I had just over $2,000 taken out of my paychecks for federal taxes (and with my tax return factored in, the total amount of federal taxes I paid was about $1,350). You would have to literally quadruple – if not quintuple – my federal taxes in order for a single-payer public insurance program to cost me the same as what I’m paying for private insurance (plus out of pocket expenses!) right now.
If you want to talk costs, I’m going to be paying for last year’s CPAP supplies until August of this year. Next month I’ll be paying off a 15 minute kidney ultrasound I got two years ago because it cost me almost $1,000. Back in 2010 I was charged over $300 for the privilege of having a camera shoved into my bladder so that I could be told that I’d probably passed a kidney stone (on top of the several hundred dollars in urgent care and emergency room bills I incurred because it turns out urine shouldn’t look like Hawaiian Punch).
Of course it’s not free. Only an idiot would think that an entire country’s health care infrastructure was being run without anyone paying a dime for it. (Well, there are morons like Rand Paul who equate Medicare for All with slavery, but I digress…) What it is is free at point of service. Just like public primary and secondary education in the US. There isn’t someone standing outside the school building asking for your $60 co-pay before they let your kid into class. And as I’ve pointed out, a public single-payer system would need to be stupefyingly inefficient – like, somehow even more inefficient than our existing dumpster fire of a system – in order for it to cost more than what we’re collectively paying right now. Even right-wing think tanks agree.
And if the right wing, which has never met a non-defense-related government program they thought could be done better and cheaper by the public sector, thinks the savings are $2 trillion over 10 years, it’s probably a good bet the actual savings would be even more substantial.
Good luck with that if you ever find yourself hit by a car and transported unconscious by an ambulance you didn’t choose to a hospital that you didn’t select where you receive a bunch of care from people you didn’t shop around for. Affordable health care should not depend on a person’s ability to haggle like they’re buying a fucking car.
In the meantime, can I borrow your galaxy brain to explain to my insurer why my in-network primary care physician no longer counts as a primary care physician despite being treated as one for the last 4 years? Because neither I nor my doctor’s office nor the provider’s billing department seem to be capable of doing so. This has been going on for 6 months now, and I have neither the time nor the energy to chase people down and sit through endless phone trees and figure out who needs to get these cryptic codes that get written down on post-it notes for me with no explanation. So I’m stuck with paying another $20 for my doctor’s visits.
I did my shopping around, and I’m still getting fucked. The entire system is garbage, and it needs to be destroyed root and branch.
For the sake of comparison, if insurance companies are averaging 3.1% profit and the rest of the allowable 15% in non-care spending is administration, that means their administrative overhead is about 12%. Meanwhile, Medicare’s administrative overhead is 1.4%.
How’s that for some savings?
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And the mandate has since been repealed, it was in face one of the first parts of the ACA that they went after.
I hope you or anyone in your family never faces a serious illness, because unless you’re VERY rich, you’re really going to be fucked. No one deserve that.
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