Health Care
- Thread starter 57Brave
- Start date
AerchAngel
<B>Secretary of Statistics</B>
And doctors don't get paid.
57Brave
Well-known member
No, doctors lived well.
I grew in an area populated with professional people.
Doctors,lawyers engineers etc all had the best of the best
I dont know if it is related but
Before the early 70's they routinely made house calls.
No go to the ER for the flu, Drs came to you
Different world
I grew in an area populated with professional people.
Doctors,lawyers engineers etc all had the best of the best
I dont know if it is related but
Before the early 70's they routinely made house calls.
No go to the ER for the flu, Drs came to you
Different world
nsacpi
Expects Yuge Games
with both medicine and education, reformers would do well to look at the bureaucratization of the two industries
you will find that the number of ahem administrators has simply exploded
the fix to me is rather obvious
and the reason the fix has not happened is also obvious: in various ways there is a bipartisan "conspiracy" that supports policies aimed at promoting the interests of the insiders as opposed to the people they are supposed to be helping (students and patients)
administrative overhead...it sounds rather mundane...but it is the reason we have bloated inefficient educational and medical systems in this country...there is a deeper question of why administrative overhead has grown so much...it is like weeds in the garden and we need to hack it down
there are a lot of good doctors and teachers who are incredibly frustrated at how much of their time is spent on paperwork
you will find that the number of ahem administrators has simply exploded
the fix to me is rather obvious
and the reason the fix has not happened is also obvious: in various ways there is a bipartisan "conspiracy" that supports policies aimed at promoting the interests of the insiders as opposed to the people they are supposed to be helping (students and patients)
administrative overhead...it sounds rather mundane...but it is the reason we have bloated inefficient educational and medical systems in this country...there is a deeper question of why administrative overhead has grown so much...it is like weeds in the garden and we need to hack it down
there are a lot of good doctors and teachers who are incredibly frustrated at how much of their time is spent on paperwork
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nsacpi
Expects Yuge Games
generally i agree...incremental change is better than wholesale social engineering...especially for something so complicated with so many moving parts
the other thing i would say is that around the world there is a wide variety of practices when it comes to healthcare...we shouldn't be so proud and arrogant as to think there is nothing to learn by looking at what other countries do
there are some unique things about American healthcare we should try to keep...the amount of innovation for example...let's not kill the things that incentivize that innovation
cajunrevenge
Well-known member
Doesnt the US government already spend more than these countries on healthcare per person? Like twice as much?
striker42
Well-known member
How do you pay for it? That's the big, central question. I'm not morally opposed to some kind of system guaranteeing healthcare for all. I have just never heard a legitimate plan to pay for it. We can't afford what we do now. How can we afford another massive entitlement program?
57Brave
Well-known member
how do you pay for it now ?
How have the above 30+ countries paid for it ? With out turning back the clock ?
yes Cajun, we do.
We are also, last I checked, in the teens in infant mortality.
All the while arguing about fetus' or some such hypocritical political nonsense.
3-2-1 " we have inovation"
which is great
But cost prohibitive to masses of people
Take some time to watch Congressional hearings from this week
How have the above 30+ countries paid for it ? With out turning back the clock ?
yes Cajun, we do.
We are also, last I checked, in the teens in infant mortality.
All the while arguing about fetus' or some such hypocritical political nonsense.
3-2-1 " we have inovation"
which is great
But cost prohibitive to masses of people
Take some time to watch Congressional hearings from this week
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57Brave
Well-known member
Congress appropriated $1.57 billion for U.S. Customs and Border Protection to build Donald Trump's wall last year. That built 1.7 miles worth of fence, according to the updates Congress has gotten from the administration. That's according to documents filed in a challenge from 20 state attorneys general and the Sierra Club to block Trump's emergency declaration to use money not appropriated by Congress for that purpose to build it.
That's going to be news to the bloated orange one, who claimed just this week that "The wall is being built as we speak. We'll have almost 500 miles of wall by the end of next year." At roughly $1 billion per linear mile, it's safe to say that's not going to be happening.
Trump's not going to let the "Haters," or reality, stop his fantasy life, however. Not when he still has Twitter. "Much of the Wall being built at the Southern Border is a complete demolition and rebuilding of old and worthless barriers with a brand new Wall and footings. Problem is, the Haters say that is not a new Wall, but rather a renovation. Wrong, and we must build where most needed…." he spluttered Wednesday morning. "Also, tremendous work is being done on pure renovation—fixing existing Walls that are in bad condition and ineffective, and bringing them to a very high standard!" he insisted in the follow-up tweet.
So, to sum up, Trump is still telling his gullible followers that he is building the wall. Also he's not building the wall. Also, Mexico still isn't paying for it.
-
Joan McCarter
Daily Kos Staff
....................
wonder how many Mamograms $1.75B would buy.
We have the money
Wonder how much Insulin $1.75B would buy
We have the money
AerchAngel
<B>Secretary of Statistics</B>
Daily Kos?
Dude, seriously?
Dude, seriously?
Julio3000
<B>A Chip Off the Old Rock</B>
No. Not even close to twice as much, although we do spend a lot per capita compared to a lot of countries that have universal coverage and better outcomes... which is just more evidence that public subsidies of private insurers and providers is a stupid system.
57Brave
Well-known member
Cant remember anyone asking that question
U.S. taxpayers have spent $81 million for the president’s two dozen trips to Florida, according to a HuffPost analysis. They spent $17 million for his 15 trips to New Jersey, another $1 million so he could visit his resort in Los Angeles and at least $3 million for his two days in Scotland last summer ― $1.3 million of which went just for rental cars for the massive entourage that accompanies a president abroad.
By S.V. Date
HuffPost
A little over $100M wont go very far granted, but,
it certainly would be a welcome
https://nypost.com/2019/01/08/inside-de-blasios-100m-health-care-for-all-plan/
striker42
Well-known member
Stuff like this and your border wall example is the equivalent of searching the couch cushions for loose change. Medicare for all, the most popular single payer option, would cost several trillion every year. You're not finding that kind of money in wasteful spending. There would have to be a major tax increase.
A lot of people seem to be under the impression that if there's medicare for all, they'll have all that money they're currently spending on health insurance premiums to spend however they want. In reality, funding medicare for all would likely require an increase in the payroll tax equal to or exceeding what most people with private health insurance already pay in premiums. This burden would disproportionately affect lower and middle income individuals.
If you think it's worth it, that's a completely valid viewpoint. Just depends on your priorities and personal feelings. I personally would like to see incremental change. Try to fix the weak points in the current system (and there are lots of them) and see where we're at.
57Brave
Well-known member
It is far more complicated than I have time today to invest, but I am curious to know how much we do spend on health insurance/medicare-Medicaid payroll deductions/ per year and how that weighs against the cost of MFA.
As in should our premiums be dedicated to one payroll tax rather than an insurance premium etc etc etc.
The operative word being for "all"
From where I sit, should we pour our health care insurance money into one pot distributed accordingly would be far more efficient than our current system.
Sort of one giant medical co-op.
That model works with utilities, credit unions and some HMO's.
And dare I say, Social Security, US post Office and Veterans Affairs
Socialist as the gripe goes -- all things being equal it works
As in should our premiums be dedicated to one payroll tax rather than an insurance premium etc etc etc.
The operative word being for "all"
From where I sit, should we pour our health care insurance money into one pot distributed accordingly would be far more efficient than our current system.
Sort of one giant medical co-op.
That model works with utilities, credit unions and some HMO's.
And dare I say, Social Security, US post Office and Veterans Affairs
Socialist as the gripe goes -- all things being equal it works
57Brave
Well-known member
Incremental change is more than likely how it will pan out, but it seems so short sighted
I also think we approach this from the wrong end. Health care should first be about care --- will very citizen get care
THEN address the cost
Some things in life, cost what they cost and you make it happen.I think I remember right- you have children, should those children contract a debilitating illness I would think cost would be the last thing that crosses you and their mothers mind.
That should be the approach rather than the cart before the horse argument the anti's pose
I want for me and my family to live in a healthy environment.
.............
Something about if there is a will there will be a way.
I am tired of watching the will getting drowned in the electoral politics of division .
As does climate etc etc etc
I also think we approach this from the wrong end. Health care should first be about care --- will very citizen get care
THEN address the cost
Some things in life, cost what they cost and you make it happen.I think I remember right- you have children, should those children contract a debilitating illness I would think cost would be the last thing that crosses you and their mothers mind.
That should be the approach rather than the cart before the horse argument the anti's pose
I want for me and my family to live in a healthy environment.
.............
Something about if there is a will there will be a way.
I am tired of watching the will getting drowned in the electoral politics of division .
As does climate etc etc etc
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acesfull86
Well-known member
http://conversableeconomist.blogspot.com/2019/05/how-single-payer-requires-many-choices.html?m=1
I sometimes hear "single payer" spoken as if it was a complete description of a plan for revising the US health care system. But "single payer" actually involves a lot of choices.
As a preview of some of these issues, its worth noting that a some prominent countries with universal health coverage and reasonably good cost control (at least by US standards!) use regulated multipayer systems, like Germany, Switzerland and Netherlands. For those who like the sound of "Medicare for All," it's worth remembering that a certain number of analysts don't consider Medicare to be a single-payer system, because of the large role played by private insurers in the Medicare Advantage program, while all of Medicare's drug benefits (in Part D of the program) are delivered by private insurers.
However, if one narrows the options to an actual single player plan, which is the label typically put on Canada, Denmark, the UK, Sweden and others, a number of questions still need to be answered.
Would the plan be run by the federal government, the states, or some third-party administration? In Canada, for example, national health insurance is best-understood as 13 separate plans run by the provinces and territories. Would the single-payer plan use a single information technology infrastructure nationwide?
Who determines exactly what services are covered or not covered by the single payer plan? Who decides when new treatments would be covered? Would the mandated package of benefits cover outpatient prescription drugs? What about dental, vision, and mental health services? These are not mandated benefits in Canada.
Would there be cost-sharing for physician and hospital services? There is in Sweden, but not in the United Kingdom. How about a limit on out-of-pocket spending? There is such a limit in Sweden, but not in the UK. Would long-term care services be covered? The answer is "yes" in Sweden, "limited" in the UK, and "no" in Canada. If there is cost-sharing, would it take the form of deductibles, co-payments, or co-insurance?
Will supplemental health insurance be allowed? "In England, private insurance givespeople access to private providers, faster access to care, or coverage for complementary or alternative therapies, but participants must pay for it separately in addition to paying their individual required tax contributions to the NHS. In Australia, private insurance covers services that the public plan does not, such as access to private hospitals, a choice of specialists in both public and private hospitals, and faster access to nonemergency care."
Would people be allowed to "opt out" of the government health insurance plan and purchase private insurance instead?
Will hospitals be publicly owned, privately owned, or a mixture? Will hospitals be paid with a global budget to allocate across patients, or by a payment based on what patients are diagnosed with what conditions, or by fee-for-service? "Currently, about 70 percent of U.S. hospitals are privately owned: About half are private, nonprofit entities, and 20 percent are for-profit. Almost all physicians are self-employed or privately employed. A single-payer system could retain current ownership structures, or the government could play a larger role in owning hospitals and employing providers. In one scenario, the government could own the hospitals and employ the physicians, as it currently does in most of the VHA [Veterans Health Administration] system."
Will doctors be salaried public employees? If they are private providers, will they be paid on a fee-for-service basis, or receive a per-head or "capitation" payment based on the number of patients they serve? In many single-payer systems, the primary care physicians are private, but the outpatient specialist physicians are sometimes (Denmark) or always (UK) public and salaried.
How are prices to be determined for prescription drugs?
Does the financing for the system come from general tax revenues (Canada), an earmarked income tax (Denmark), a mixture of general revenues and payroll taxes (UK), or some other source?
I sometimes hear "single payer" spoken as if it was a complete description of a plan for revising the US health care system. But "single payer" actually involves a lot of choices.
As a preview of some of these issues, its worth noting that a some prominent countries with universal health coverage and reasonably good cost control (at least by US standards!) use regulated multipayer systems, like Germany, Switzerland and Netherlands. For those who like the sound of "Medicare for All," it's worth remembering that a certain number of analysts don't consider Medicare to be a single-payer system, because of the large role played by private insurers in the Medicare Advantage program, while all of Medicare's drug benefits (in Part D of the program) are delivered by private insurers.
However, if one narrows the options to an actual single player plan, which is the label typically put on Canada, Denmark, the UK, Sweden and others, a number of questions still need to be answered.
Would the plan be run by the federal government, the states, or some third-party administration? In Canada, for example, national health insurance is best-understood as 13 separate plans run by the provinces and territories. Would the single-payer plan use a single information technology infrastructure nationwide?
Who determines exactly what services are covered or not covered by the single payer plan? Who decides when new treatments would be covered? Would the mandated package of benefits cover outpatient prescription drugs? What about dental, vision, and mental health services? These are not mandated benefits in Canada.
Would there be cost-sharing for physician and hospital services? There is in Sweden, but not in the United Kingdom. How about a limit on out-of-pocket spending? There is such a limit in Sweden, but not in the UK. Would long-term care services be covered? The answer is "yes" in Sweden, "limited" in the UK, and "no" in Canada. If there is cost-sharing, would it take the form of deductibles, co-payments, or co-insurance?
Will supplemental health insurance be allowed? "In England, private insurance givespeople access to private providers, faster access to care, or coverage for complementary or alternative therapies, but participants must pay for it separately in addition to paying their individual required tax contributions to the NHS. In Australia, private insurance covers services that the public plan does not, such as access to private hospitals, a choice of specialists in both public and private hospitals, and faster access to nonemergency care."
Would people be allowed to "opt out" of the government health insurance plan and purchase private insurance instead?
Will hospitals be publicly owned, privately owned, or a mixture? Will hospitals be paid with a global budget to allocate across patients, or by a payment based on what patients are diagnosed with what conditions, or by fee-for-service? "Currently, about 70 percent of U.S. hospitals are privately owned: About half are private, nonprofit entities, and 20 percent are for-profit. Almost all physicians are self-employed or privately employed. A single-payer system could retain current ownership structures, or the government could play a larger role in owning hospitals and employing providers. In one scenario, the government could own the hospitals and employ the physicians, as it currently does in most of the VHA [Veterans Health Administration] system."
Will doctors be salaried public employees? If they are private providers, will they be paid on a fee-for-service basis, or receive a per-head or "capitation" payment based on the number of patients they serve? In many single-payer systems, the primary care physicians are private, but the outpatient specialist physicians are sometimes (Denmark) or always (UK) public and salaried.
How are prices to be determined for prescription drugs?
Does the financing for the system come from general tax revenues (Canada), an earmarked income tax (Denmark), a mixture of general revenues and payroll taxes (UK), or some other source?