The Goat Pen

Single payer has some merits. In the countries that have it, their citizens like it, and would attack anybody who wanted to take it away from them. But there would be significant downsides if we implement it here:

Americans like being able to get an MRI within a day or two. They won't like being on a waiting list for MRI than can last for months.

Americans like constant advancements in medications and treatments. Under single payer, drug companies won't bother with expensive R&D because there will no longer be any profit in doing so. Whatever the status of medicine is when single payer starts will be the same for decades.

Older Americans like being treated for their serious health care issues. Under single payer, sick grandma and grandpa will be told by some government bureaucracy that there are no funds available in the current quarter to treat 80+ year olds with diabetes and failing heart valves. The official government algorythms will dictate that they do not qualify for expensive corrective surgery because their demographic just isn't worth the expense. They will be given pain medication and sent home.

Finally, the government has a pretty bad record at customer service. Whenever you go to the DMV or IRS, did you feel the love? With that in mind, if you want to see what government-run health care looks like, just look at the VA. We need to think long and hard if before we make our entire health care system run like that monstrosity.

yea

medicaid and medicare functions because the government just writes a check to the health care providers and until recently they were all to happy to take the blank check - and the reason the system worked is because they took advantage of a capitalistic health care system made accessible by the millions of private citizens footing the bill for the infrastructure and the salaries/profits necessary to keep us flush with doctors, researchers and drug companies. Medicare and Medicaid are just government run insurance programs. They won't even negotiate with the drug companies to lower prices because lobbyists have their hooks in them. They have $60 billion a year in fraud. That's enough money to feed every homeless person in America for a year, send 750K kids to college and buy books for every college student. Throw $3b in more and you could also house every homeless person in America for a year.

The VA? That's your government run health care system - people dying while government bureaucrats gets bonuses by hiding them in the system.

Does anyone really want politicians that can be bought and owned to be making decisions about how much money a health care provider should be forced to spend on you to give you quality of life and/or prolong your life? They do it too much now and look at the mess we have.

It seems lost on so many people - on one hand they complain about how incompetent the Trump administration is and then on the other they want the government to run health care, schools, energy , the list goes on and on

"Does anyone really want politicians that can be bought and owned to be making decisions about how much money a health care provider should be forced to spend on you to give you quality of life and/or prolong your life? "

Or if you should be allowed to use heroin...

But we're headed toward no health care. Like I told you a few weeks ago, it's coming for you too. Don't ask me for a Kleenex when it does. I'll already be dead

health care probably went off the rails when it became tied to employee benefits.

The quality of the health care you receive is based on the quality of the job you have and/or the quantity of employees a company has.

If the government had to be involved in health care, it should mandate that insurance companies offer 4 or 5 different health care plans that are essentially the same no matter who you get them from and make all health care plans available nationwide. Personally I think if they do that, then they should also have some built in protections for the consumer such as limiting the size of the deductible to 5% of the median household income. The deductible has made it impossible for anyone to compare health care coverage and it needs to be standardized or eliminated. Finally they should shift everyone to these plans including senior citizens, the disabled, veterans, politicians, etc. Then the government can decide who and how much they want to subsidize for these plans taking all obligations into consideration.

Insurance companies should make the rates/plans they offer to all business/individuals transparent. If you work for General Electric or if you work for Bob's Hardware, this is what the cost for this plan is for each person. No one ever really knows if what the company is telling them about benefits is true, you just have to take their word for it. A company may say they are absorbing 70% of the health care cost per employee but having to raise the rates to cover the rest when the reality is they are shifting the burden to 60% on the employee. Take Wal-Mart telling people that 80% of their employees have health insurance but not telling you that number is comprised of employees being on spouse plans, medicare, medicaid and other forms of government assistance, along with them offering a major medical plan that was virtually subsidized by them,

The last part of this for the consumer is all medical records should be digital and part of a nationwide network. A doctor in Oregon should be able to pull up your complete medical history even if you're vacationing from Ohio. That would eliminate the need for a family doctor or hospital.

That would address some issues - 1. everyone now can competitive shop for the same benefits like they do with the auto industry 2. Everyone becomes knowledgeable about what the health care plans provide or don't provide. 3. The insurance processing is streamlined because hospitals no longer care what insurance company you are with, only which policy you have. 4. People no longer care (unless they want to) which doctor or hospital they go to. All hospitals take the standard plans and all of them have complete access to your medical history. " 5. Provide a kickback to any insured person who spends less than say $2000 a year in medical expenses. Throw them a $500 rebate or voucher that encourages them to seek the most affordable health care possible. 6. Now providers will compete for your business, especially if employers are encouraged to stop providing it as a benefit, and health care providers will tailor their offerings to these plans. You'd see hospitals advertising "the best plan X provider in New York -by suggesting they can serve your medical needs and help you get your voucher, or providing perks that others don't.

Even all that is only half the problem. The other side of the problem is virtually no price controls. If you want to lower the price of anything in a capitailistic market, you create more supply and less demand. The system we have today is doing the opposite - fewer doctors - at least general practitioners, limited availability of new life saving drugs, etc.,
There are actions that could be taken - forgiving student loans for doctors who agree to practice providing specific types of health care in specific locations for at least 10 years., shortening the patent on drugs or invest in research - Think about if Trump said in the next 5 years cancer is going to be treated like we treat whooping cough and set the nation to solving it like Kennedy said we'd put a man on the moon. Eliminate cancer and health care costs drop by 30% (out of my ass guess).

If you don't create an environment that encourages more doctors, more hospitals, more research - then our health care becomes just like the airlines. 3 or 4 companies treating you as shitty as possible trying to squeeze every dollar out of you.

But at the end of the day , its capitalism. And capitalism says that not everyone gets a seat at the table, not everyone gets to drive a new corvette and shop at Williams and Sonoma. There is going to be a bunch of people driving a dodge caravan and shopping at Wal-mart, and health care in a capitalistic system is no different.

There are two problems:

One problem is that no one has the stomach to discriminate the level of health care by economic circumstances. The financially viable healthcare solution is to provide a basic level of care for those who need subsidized for their healthcare. They have to wait for surgeries, they stay in wards and not single rooms, they can't sue their healthcare providers, etc. Kind of like the poor man's V.A. The folks that have jobs that provide, or are willing to pay for their own, get the better care. I know it may not be fair, but its the only way that this can possibly work.

Secondly, Medicare and SS needs to raise the age to 72. If you physically can't work, then apply for disability, but the majority of folks between 67 and 72 can still work.

I was hoping they'd lower it to, say, 60 years old. I'm bout ready to retire. This work shit is for the birds...

I just retired at 57.... SUCKAHHH!

Before Obamacare, the private sector provided excellent healthcare at runaway prices that were impossible for lower income people to afford.

Under Obamacare, the private-public hybrid provided excellent healthcare at runaway prices that were impossible for lower income people to afford.

Under whatever replaces Obamacare, the healthcare system will provide excellent healthcare at runaway prices that will be impossible for lower income people to afford.

I didn't have health insurance until probably 5 years ago, and I wish I never got it when I did. Just take your chances until you hit 65 and then you're on Medicare anyway. Maybe buy a small supplemental policy at that time. Obviously insurance companies are making billions on this product, which means they are collecting way more than they're paying out...

"The last part of this for the consumer is all medical records should be digital and part of a nationwide network. A doctor in Oregon should be able to pull up your complete medical history even if you're vacationing from Ohio."

Or if you're eCat, you can rent a car in Ohio and drive the medical records out to a doctor in Oregon...

hedge wrote:"The last part of this for the consumer is all medical records should be digital and part of a nationwide network. A doctor in Oregon should be able to pull up your complete medical history even if you're vacationing from Ohio."

Or if you're eCat, you can rent a car in Ohio and drive the medical records out to a doctor in Oregon...

I've been doing that for years

"Eliminate cancer and health care costs drop by 30% (out of my ass guess)."

Yeah, but then you're going to be paying more later when we've got a bunch of 100 year olds with Alzheimers and whatnot...

"There is going to be a bunch of people driving a dodge caravan and shopping at Wal-mart, and health care in a capitalistic system is no different."

Maybe WalMart should go into the health care business...

hedge wrote:"Eliminate cancer and health care costs drop by 30% (out of my ass guess)."

Yeah, but then you're going to be paying more later when we've got a bunch of 100 year olds with Alzheimers and whatnot...

"There is going to be a bunch of people driving a dodge caravan and shopping at Wal-mart, and health care in a capitalistic system is no different."

Maybe WalMart should go into the health care business...

raise the retirement age to 89

Hell, there's not enough work for people under 65 right now, and that's just going to get worse as technology advances. What's going to happen when people just stay in their jobs for another 20 years? Nobody in their 20's will be able to get a job, and the country will be ravaged by rage directed at elders. Elder rage will rule. It will be an ugly time. Esp. for elders...

hedge wrote:Hell, there's not enough work for people under 65 right now, and that's just going to get worse as technology advances. What's going to happen when people just stay in their jobs for another 20 years? Nobody in their 20's will be able to get a job, and the country will be ravaged by rage directed at elders. Elder rage will rule. It will be an ugly time. Esp. for elders...

Millineals hate Boomers already

Take Stephen Hawkings' advice:


“We are running out of space and the only places to go to are other worlds,” Hawking said. “It is time to explore other solar systems. Spreading out may be the only thing that saves us from ourselves. I am convinced that humans need to leave Earth.”

I wish you would leave Earth...

There have actually been some pearls offered up here wrt the healthcare conundrum.

health care probably went off the rails when it became tied to employee benefits.

There's no 'probably' about it. An incredibly ill-conceived concept, our very own - no other developed nations went down this path to failure. America has had much more success quitting smoking than ditching the employer healthcare model.

The financially viable healthcare solution is to provide a basic level of care for those who need subsidized for their healthcare. They have to wait for surgeries, they stay in wards and not single rooms, they can't sue their healthcare providers, etc. Kind of like the poor man's V.A. The folks that have jobs that provide, or are willing to pay for their own, get the better care. I know it may not be fair, but its the only way that this can possibly work.

This kind of two-tiered hybrid is what I've been pushing since the late '90s. A low cost fundamental program with emphasis on preventive care, a notch above medicaid (that would remain for the poorest and those unable to handle their own affairs). The upper tier continues as the employer model we're stuck with, along with tonier individual plans that the affluent can afford.

Our patchwork healthcare system needs an overhaul for sure, but this Senate bill is merely a tax cut for the top 2%. And obviously the only way to pay for that tax cut is to gut or eliminate Medicaid. Mean. Sad.

Yeah, the developed nations of the world (green) have universal healthcare. We'll join them eventually. Probably. It may be after half of Africa and all of South America is green, but our day'll come.

The good thing about getting old is not having to give a shit. Someone pisses you off at Bojangles? Shoot their ass. Oh, he's just old, they'll say.