Healthcare Hypocricy?

[CBB_Fan]

Ooooh, YOU have addressed it several times, therefore it must be proved. I see.

I didn't say single payer insurance wouldn't be cheaper than what we have now. I'm saying single-payer insurance will be more expensive with less quality than we would have if we dropped medicare and medicaid. In other words, remove government interference from the free market system and watch premiums and medical costs free fall.

Here it is again, combined state + federal spending as a percent of GDP, demonstrating pre-government interference levels with a slope of about 1 percent/70 years versus a slope of about 6.75 percent/45 years!



The government's own chart clearly shows that health care spending by our governments is approaching other country's spend per GDP _by itself_ -- forget the private sector. It also clearly shows that slope began in the late 1960's/early 1970's. That's to cover 30% of the population! In other words 7% of our GDP, which is entirely under the government's regulation, is spent on health care to cover 30% of the population. And that coverage doesn't provide equal access to health care, by the way.

But you want MORE of it.

An entire magnitude in spending increases has occurred since the government began interfering in the free market system. To you that's just a coincidence. 60+ years of precendence means nothing.

A single payer system would also definitely curb the costs of what we see now, but not NEARLY as well as the free market system has already proven it would, and with the additional extremely negative side effects of reduced quality in health care and choices.

I bolded your repeated mention of the "free market," because here is where your biggest misconception lies. If we completely removed federal subsidies from healthcare, we would not have a free market system. A free market system requires more than just a lack of government interference to work.

What have now is a government subsidized system of regional monopolies. Again, monopolies are not conducive to free market practices and do not give consumers the benefits that free markets systems do. For a free market to work, the following needs to be in place:

1. Transparent, easily available prices so that consumers can make price-based decisions
2. A balance between the consumers need for the product, and the producer's need to sell it.
3. Competing businesses, without any business having such an advantage that they can ignore their competitors
4. Consumer choice between those businesses

Our current system relies on employer funded healthcare, which right from the start eliminates most of the competing businesses from the picture. It further reduces the number of competing businesses by forbidding insurance sales across state borders (this because we do not have national minimal standards, which would give certain states huge advantages and create income inequality).

Even if the consumer can choose between multiple companies, they have no idea what they are buying, or how much it will cost. Insurance companies decide which hospitals, doctors, and procedures are covered, and they don't give that information out in advance. And prices are completely detached from supply and demand, because they are decided arbitrarily by hospital CFOs instead of being driven to equilibrium.

Our government does nothing to stop any of that, and THAT is the main problem. They collude with insurance companies and pass legislation designs to protect profit margins instead of trying to produce meaningful change in our healthcare system. Because they simply subsidize rates that are decided on a 3rd party's whims, they continue to overspend and waste money, but eliminating them would not remove the core problem with the US system.

I've proposed two solutions that would fix this, and reduce costs for both the government and the people. The first is a single payer system where the free market is limited to supplemental insurance, but all basic healthcare is funded by government. The advantages of that system are that it would allow consumer's to have more doctor/hospital choice and would almost certainly reduce costs for everyone involved, as seen in most healthcare systems in the world. The main disadvantage is slower service and longer wait times for non-emergency services.

The second solution is a Swiss-style free market based system where anyone in the country can choose from any insurance provider (employer-based healthcare eliminated) for their insurance, but minimum standards and mandates are set by government (and basic plans are non-profit). This would also reduce costs and eliminate monopolies while allowing for private insurance companies to still control the process. The primary downsides are less hospital/doctor choice, and that mandates have to be carefully applied or they will be crippling to poor families (in most places yearly expenses are capped at 10% of a families income before subsidies start paying for everything).

In both cases, the primary driver of America's inflated prices would be eliminated and costs would go down for both the government and the people. People would also have far more choice than they do now, both in terms of hospital/doctor choice and in terms of making free market decisions. For either to work, we need to require transparent costs for each procedure/drug, eliminate employer-funded healthcare (which is also job-killing), and set national minimum standards while allowing insurance to be sold across state lines.

Those are solutions to the problem. Simply saying that the government needs to stop subsidizing healthcare is not a solution, and would get us no closer to free market system.

[SB Shock]

I like Swiss cheese.

[MoValley John]

why would anyone need, or even want to buy supplimental insurance under a single payer system? This really needs to be answered.

[MoValley John]

I guess nobody on tbe left wants to answer my simple question.

[Downtown Shocker Brown]

I guess nobody on tbe left wants to answer my simple question.

They are waiting for the talking points. None of them are smart enough to formulate an opinion on their own. They need a teleprompter.

[CBB_Fan]

I assumed the question was rhetoric, because the answer was obvious (and besides the point, people DO purchase supplemental insurance in the countries with single payer systems). People buy supplemental insurance for the same reason they buy more expensive plans or take healthcare outside of that offered by an employer now: because they want more coverage.

[MoValley John]

I assumed the question was rhetoric, because the answer was obvious (and besides the point, people DO purchase supplemental insurance in the countries with single payer systems). People buy supplemental insurance for the same reason they buy more expensive plans or take healthcare outside of that offered by an employer now: because they want more coverage.

Single payer, in its truest form, should cover everything. It doesn't. And that is the rub. If it doesn't cover everything, it isn't single payer. And since this whole debate is about covering those who cannot afford coverage, the poor still will not have adaquate coverage without purchasing supplimental coverage, so all the feel good of single payer fixes nothing.

The real answer is in how we best care for our elderly, not single payer, not free market. Our healthcare system is expensive because of Medicare. Medicare costs get shifted to the insurance companies, who pass costs to rate payers. If you want to know the dirty little secret of the European, single payer systems, THEY NEGLECT THE ELDERLY! Dont believe me, I can post proof.

As I've said before, the problem is Medicare, neither Republicans nor Democrats have the balls to even address the true problem.

[MoValley John]

http://www.telegraph.co.uk/health/el...hospitals.html

This is how single payer works. Neglect the elderly. This example is the norm, not the exception. Taking care of the elderly is expensive and has zero return. When we talk of reeling in healthcare costs, we first need to decide how we want to take care of grandma. Who wants to have an honest discussion?

[MoValley John]

http://www.theguardian.com/social-care-network/2012/jan/11/growing-problem-elderly-care-france

How the French do single payer in regards to the elderly.


"Campaigners warn that more pensioners would be condemned to longer stays in hospitals and that relatives would have to give up work to look after them; which would have the opposite effect of cutting down the cost of caring for the elderly."

[MoValley John]

http://govinfo.library.unt.edu/chc/r...es/hrfig03.jpg

The real problem with US healthcare costs. If single payer is implemented without addressing the cost of elderly care, you have fixed nothing.

[MoValley John]

How Japan deals with geriatrics:

http://mobile.businessweek.com/artic...nd-dying-alone

Sicko indeed!!!

[CBB_Fan]

Single payer, in its truest form, should cover everything. It doesn't. And that is the rub. If it doesn't cover everything, it isn't single payer. And since this whole debate is about covering those who cannot afford coverage, the poor still will not have adaquate coverage without purchasing supplimental coverage, so all the feel good of single payer fixes nothing.

The real answer is in how we best care for our elderly, not single payer, not free market. Our healthcare system is expensive because of Medicare. Medicare costs get shifted to the insurance companies, who pass costs to rate payers. If you want to know the dirty little secret of the European, single payer systems, THEY NEGLECT THE ELDERLY! Dont believe me, I can post proof.

As I've said before, the problem is Medicare, neither Republicans nor Democrats have the balls to even address the true problem.

1. Single payer is a method of funding, not an obligation to pay all expenses. While it is true that it pays for everything, that solely refers to the fact that all the money received by hospitals comes from the government. In no form of single payer is the government obligated to pay for all healthcare at no cost to the tax payers.

2. You target France and Japan ... which have the #1 and #4 best life expectancy in the world (US is #33). The main reason they have higher elderly expenses is that their elderly tend to live to old age.

3. Your link about Japan is about changing cultural expectations, not the failure of a government healthcare system.

4. The costs quoted in the France article were €1500 to €2000 per month or $24,000 to $32,000 a year. The complaint is that those prices were prohibitively expense. Costs in the US are much higher, at around $45,000 for homemaker services, $40,000 for an assisted living facility, and $75,000 for a nursing home.

5. Your argument ignores the fact that elderly abuse happens under the current system as well. Going from your source for the graph:

• The most recent major studies on incidence reported that 7.6%–10% of study participants experienced abuse in the prior year.^6,7 The study that found an incidence of 1 in 10 adults experiencing abuse did not include financial abuse.⁸
• Available data from state Adult Protective Services (APS) agencies show an increasing trend in the reporting of elder abuse.
• Despite the accessibility of APS in all 50 states (whose programs are quite different), as well as mandatory reporting laws for elder abuse in most states, an overwhelming number of cases of abuse, neglect, and exploitation go undetected and untreated each year.
• One study estimated that only 1 in 14 cases of elder abuse ever comes to the attention of authorities.⁹ The New York State Elder Abuse Prevalence Study found that for every case known to programs and agencies, 24 were unknown.¹⁰
• Major financial exploitation was self-reported at a rate of 41 per 1,000 surveyed, which was higher than self-reported rates of emotional, physical, and sexual abuse or neglect.

And thus elderly abuse and neglect are problems that universally affect every healthcare system, whether they use a single payer system, a private insurance system, or a mix. While I agree that it is a big problem (and a growing one), it should not be used as an argument against shifting to a better system. Ideally elderly care would be through a separate system that would provide living services and care while also protecting the elderly from their relatives, and that system would operate independently from the system that services the general public (as the elderly need much higher levels of minimum care).

[MoValley John]

Single payer, as a system, should cover all costs of healthcare through government funding (taxes). If the government cannot deliver healthcare in this manner, the poor, once again, are adversely harmed. The failure in single payer in Europe is that the poor, just like in the US, are the people that dont receive adaquate care.

In the US, the elderly are cared for because we demand it. The demand for quality geriatric care in the US, combined with the government shifting costs to the peivate sector, balloon insurance premiums. Countries with single payer systems simply cannot afford to take care of their elderly, so they don't. Its their dirty little secret.

[MoValley John]

http://www.telegraph.co.uk/health/el...ng-reform.html

I can go on and on. These countries that "rank highly" in healthcare, do not provide adequate healthcare to the elderly. Furthermore, they have no idea how to fix the problem. As the articles point out, with regard to expensive elder care, single payer simply can't afford to provide care to the aged.

[Kung Wu]

Bah, I'm gone for a few days and this thread gets away from me.

"Monopoly." Seriously?

"Collusion." What?!

"Employers subsidizing employees prevents competition." Huh? You don't have to take your employer's insurance -- feel free to sign up for 1,000's of other organization's group insurances.

"Consumers don't know what they are buying." Because they can't read due to being publicly educated? Or because they can't afford a free Obama phone which they could use to call their insurance agent to ask what's covered?

"And prices .. are decided arbitrarily by hospital CFOs" Yes, insurance companies who actually have to cover the bills and their expert negotiators, are incentivised to buy hospital CFO's large luxury yachts -- good well thought out point there. In fact, doctors and hospitals are complaining about the EXACT OPPOSITE ... that they are being undercut due to databases compiled by insurance companies to know how far down they can push the prices (example: http://www.kevinmd.com/blog/2012/03/...otiations.html).