Single Payer

[ShockCrazy]

This is actually a good demonstration of why our current healthcare system doesn't work, from the private side.

You didn't make the choice to switch trash companies. Someone else did, and they have entirely different motives. In a totally free market, the previous trash company would win out, but to the government official in charge of negotiating trash contracts things are different. They just want to tell their boss they cut costs and saved money.

How is that related to private healthcare? Employers. In the same way that someone chose your trash company, your employer probably chose your health insurance company. And that comes with all the same problems.

My position is that either single payer or an actual free market (private citizens buying their own healthcare with visible costs) would reduce health expenses considerably.

I very much agree with your final statement. I think a true and free market could work with visible costs, but I don't think healthcare is necessarily suited to it. It's hard to know upfront cost. And in all urgent cases it is impossible to shop for care. If I'm having a heart attack I'm not going to the internet to see who will provide the care cheapest, I'm going to the closest I can immediately.

[Rocky Mountain Shock]

Regarding cost increases in the 1960s: correlation does not mean causation. Perhaps the creation of Medicare caused more people to seek medical services, thereby increasing demand. Add in the effects of the baby boom, fast food and other poor lifestyle choices, and you have ever increasing demand that supply has not yet been able to catch up with.

Regarding private sector efficiency: anyone who has spent anytime in a public sector job knows how much investment government does NOT make in itself. Whether it's schools, roads, or virtually anything else except possibly the military, government agencies and departments largely run on shoe string budgets, pay their people less than they are worth in the private sector, and rarely update technology and infrastructure. Government has to do more with less because nobody likes paying taxes and no politician wants to raise taxes. Private companies have easier access to capital and are able to invest in new technology and new processes that will make them more efficient. Government exists to provide services, not to turn a profit, and oftentimes those services are not lucrative endeavors. Trying to compare the two sectors is pointless--they exist for two entirely different purposes. It's a given that a single-payer system will run less efficiently than private insurance carriers. But for me, while cost is a factor in the decision of whether or not to move forward with single-payer, it isn't the driving factor.

[RoyalShock]

Kind of off topic, but if you outlawed employer sponsored health insurance, one would know if they were working for greedy SOBs if they did not receive an immediate raise.

Interesting idea to contemplate. Not really for it personally, but interesting to think about the effect of that move.

Not necessarily. A wise business would wait and see what its competitors do. If they all drop the price of their product/service due to lower labor cost while you keep yours the same because you transferred those saving to the employees instead of your customers, you might not be in business for long.

[wufan]

Not necessarily. A wise business would wait and see what its competitors do. If they all drop the price of their product/service due to lower labor cost while you keep yours the same because you transferred those saving to the employees instead of your customers, you might not be in business for long.

Probably what you would see is a bidding war for highly industries people. I can still pay my non-union machines $25 an hour, but I can how offer a VP from a competing company $250K instead of $200k. This could actually increase the wealth gap and produce a negative consequence. Very interesting topic.

[wufan]

This is actually a good demonstration of why our current healthcare system doesn't work, from the private side.

You didn't make the choice to switch trash companies. Someone else did, and they have entirely different motives. In a totally free market, the previous trash company would win out, but to the government official in charge of negotiating trash contracts things are different. They just want to tell their boss they cut costs and saved money.

How is that related to private healthcare? Employers. In the same way that someone chose your trash company, your employer probably chose your health insurance company. And that comes with all the same problems.

My position is that either single payer or an actual free market (private citizens buying their own healthcare with visible costs) would reduce health expenses considerably.

I also agree mostly with this. Medicine should be a highly regulated field, but it's not going to be cheap when you do that. The free market is not at all on play currently, thus we have lost our intrinsic price control.

Perhaps, rather than worrying about who's paying, we should worry about what we are paying for. Is it really necessary to get a prescription for an asthma inhaler? Perhaps some refs should be reconsidered.

[wufan]

Single payer wait times were kinda glanced over earlier. I stumbled across an article that looked at a few various surgeries, one of which was hip replacement. The wait time for this is 30-60 days in Sweden, about 90 days in England, and I believe 5 months in Canada. It's 20 days in the US. On ER visits, the average wait in the US is about 2 hours, with 4 hours being the longest. In other countries, wait time is measured in % greater than 4 hours, where Canada faired the worst with about 60% greater than that.

Longer wait times are certainly something to consider (rationing/frustration), but is the consequence of waiting detrimental to ones health?

[ShockerPrez]

Not necessarily. A wise business would wait and see what its competitors do. If they all drop the price of their product/service due to lower labor cost while you keep yours the same because you transferred those saving to the employees instead of your customers, you might not be in business for long.

That is true, a lot of factors in play. But if I knew that my employer was not paying the cost of health indurance, and as long as payroll taxes on the business held the same, I would expect some of that cost savings be sent back to me in wages.

[Jamar Howard 4 President]

The best run government program is way inferior to the worst run non-government company.

I can't take seriously any person who would say such a thing. Stupid beyond belief.

[Jamar Howard 4 President]

Insurance agencies give jobs to people. They take the premiums and invest them in other businesses that employee other people. This activity creates tax revenue.

This brings up a pet peeve of mine that both left and right often fall into. Not all jobs are equal. In fact, adding jobs can actually be a net negative in some cases. The key is adding jobs that create new value, or that add efficiency.

If a company hires a new employee, but simply allows all its others employees to slack off a little more while at the office, and no additional output is achieved, then the job was not a net positive for society. Sure, that one employee now gets a paycheck, but it is effectively a waste of human hours accomplishing nothing. It is like paying one person to push a rock 100 feet, then another person to push the rock back where it came from.

We have all become richer as efficiency has improved. It doesn't take all day to mow my yard with hand tools because I have a lawn mower that can do it in 30 minutes. I have all that extra time to do other things and be more productive.

How does this relate to insurance? Well, the best, most efficient scenario is the one where folks are insured via the fewest possible agents spending the fewest possible hours to do so. Notice I'm not arguing pro/anti government involvement per se. I'm just saying that some times, it is good to make jobs obsolete.

Simplifying the tax code and reducing the number of folks providing tax services would be #1 on my list of easy ways to improve society by a REDUCTION in a specific type of job, but that's a whole other topic.

[Aargh]

On the subject of job creation, I have one thing that bothers me - bigly.

WalMart claims they create jobs and just count the people they've hired. If the community is still buying the same amount of "stuff", other businesses in the community will be eliminating jobs. WalMart's scale makes their operation more efficient than the smaller businesses they displace, so there's probably a net loss of jobs, but "job creation" is still claimed.

Brownback claimed credit for creating a bunch of jobs when Amazon located a distribution center in the KC area. All Amazon had actually done was move their distribution center from southeast Kansas to northeast Kansas. That doesn't create jobs. It just moves them around, but "job creation" is claimed because that's politically helpful.

[ShockCrazy]

This brings up a pet peeve of mine that both left and right often fall into. Not all jobs are equal. In fact, adding jobs can actually be a net negative in some cases. The key is adding jobs that create new value, or that add efficiency.

If a company hires a new employee, but simply allows all its others employees to slack off a little more while at the office, and no additional output is achieved, then the job was not a net positive for society. Sure, that one employee now gets a paycheck, but it is effectively a waste of human hours accomplishing nothing. It is like paying one person to push a rock 100 feet, then another person to push the rock back where it came from.

We have all become richer as efficiency has improved. It doesn't take all day to mow my yard with hand tools because I have a lawn mower that can do it in 30 minutes. I have all that extra time to do other things and be more productive.

How does this relate to insurance? Well, the best, most efficient scenario is the one where folks are insured via the fewest possible agents spending the fewest possible hours to do so. Notice I'm not arguing pro/anti government involvement per se. I'm just saying that some times, it is good to make jobs obsolete.

Simplifying the tax code and reducing the number of folks providing tax services would be #1 on my list of easy ways to improve society by a REDUCTION in a specific type of job, but that's a whole other topic.

Ohhhh this last one for certain. I really don't mind that I have to pay taxes or really the amount I have to pay currently, I FREAKING hate how I have to either pay someone to figure out how much I owe or spend twenty hours plus figuring it out myself, and regardless at the end I feel paranoid something was screwed up.

[ShockTalk]

On the subject of job creation, I have one thing that bothers me - bigly.

WalMart claims they create jobs and just count the people they've hired. If the community is still buying the same amount of "stuff", other businesses in the community will be eliminating jobs. WalMart's scale makes their operation more efficient than the smaller businesses they displace, so there's probably a net loss of jobs, but "job creation" is still claimed.

Brownback claimed credit for creating a bunch of jobs when Amazon located a distribution center in the KC area. All Amazon had actually done was move their distribution center from southeast Kansas to northeast Kansas. That doesn't create jobs. It just moves them around, but "job creation" is claimed because that's politically helpful.

A better way to put this was that he may have Saved Kansas jobs. Don't know the particulars, but Amazon was most likely "looking for something", either from Kansas or elsewhere.

[Jamar Howard 4 President]

Ohhhh this last one for certain. I really don't mind that I have to pay taxes or really the amount I have to pay currently, I FREAKING hate how I have to either pay someone to figure out how much I owe or spend twenty hours plus figuring it out myself, and regardless at the end I feel paranoid something was screwed up.

Income tax season literally requires more than a billion hours of manpower just to calculate what is owed to the government.

Just to calculate!

Such an incredible waste, yet if a proposal to simplify the tax code was on the table, there would be those complaining about all the lost jobs.

[jdshock]

Income tax season literally requires more than a billion hours of manpower just to calculate what is owed to the government.

Just to calculate!

Such an incredible waste, yet if a proposal to simplify the tax code was on the table, there would be those complaining about all the lost jobs.

One of the craziest parts to me is that citizens are tasked with actually calculating it. The vast majority of people are calculating tax returns with the exact same information that is already available to the US government. We could just be like other countries and not require returns for the majority of people.

This is another example of a proposal that would likely cost the US government money (let's at least assume that it would cost some additional amount of money, but I'm not actually sure it would cost that much), but radically increase efficiency because you would not have hours and hours spent on taxes on both sides of the equation.

[Aargh]

One of the craziest parts to me is that citizens are tasked with actually calculating it. The vast majority of people are calculating tax returns with the exact same information that is already available to the US government. We could just be like other countries and not require returns for the majority of people.

This is another example of a proposal that would likely cost the US government money (let's at least assume that it would cost some additional amount of money, but I'm not actually sure it would cost that much), but radically increase efficiency because you would not have hours and hours spent on taxes on both sides of the equation.

I'd like to address your last comment. In both government and private enterpises, you better have a better power base than the head of a department if you want to create efficiencies in that department.

If you reduce work loads, paper flows, or anything else anywhere in someone's "little kingdom", you reduce their staffing and reduce their budgets. That takes power away from them. They will fight with every known or unknown tactic to maintain their power base and their budgets.

When I was doing a lot of computer work I found one form where my clients would print information off of their computer. Then they would give the printout to someone who would hand-write the same information (printed - all caps in little boxes for data entry) and mail it to Topeka. In Topeka, they would give the paper to a data entry operator who would enter the info from the little boxes all filled out in capital block letters.

I asked one of my clients whether the State had a way of just sending info from the computer on this end to the computer on the other end. They asked the State if that was possible and all hell broke loose. It was such a good idea that once the subject was actually spoken, it had to be addressed, so the communication was set up - with a set of requirements that were incredibly complex and entirely unnecessary. The attempt was absolutely sabotaged.

Any who dared attempting to use that process had claims rejected for any and every made up problem that could be imagined. That resulted in delayed payments for months while rejections and resubmissions went back and forth. Everybody stopped using the process. Eventually word of what was going on got to someone at a higher level who had the ability to order it done. That took several years.

It's not just government. People are people regardless of where they work and people will fight tooth and nail to preserve their position of power and authority and sabotage any attempt to downsize their little kingdoms.