Single Payer Health Care--US

[Gregory Matthews]

It should surprise no one that I am interested in health-care,  as an individual who receives healthcare, as a former clinician providing care and as a U.S. tax payer living in a country with high costs associated with health care.

I am posting this in an attempt to provide information in this complex issue  to U.S. residents and citizens who may be interested in this subject.  I am only attempting to provide information and I do not take a position on the various issues that are a part of the situation in the United States.

While I am writing in my own words, my post is based upon the following article by the Editors of Bottom Line Personal:

“How Much Single-Payer Health Care Would Really Cost.”  Bottom Line Personal,  November 1, 2018, pages 8 -  10.

In preparing for this article, the Editors of Bottom Line Personal interviewed:  Robert Graboyes, PhD, Research fellow at George Mason University,  Jonathan Oberlander, PhD Professor of health policy at the University of North Carolina and Jodi Liu, PhD Policy researcher at the Rand Corporation.  More information about them may be found in the original article.

NOTE:  It should be clearly understood that this post includes brief statements that I have made based upon the article.  While some words may have come directly from the article,      other words are of my choice.  I encourage all to review the original article for a better understanding of what is said in my brief post.

What Is Single-Payer Health Care?

In brief, a national health care plan would replace all of the provisions of paying for health care that exist today.   Medicare, Medicaid, Obamacare and other such would be replaced.  Every one would be covered, regardless of any preexisting conditions.  Co-pays and deductibles would not exist.  Taxes would fund the program.  No one would have any out-of-pocket expenses.  This would include vision, dental and hearing expenses, as well as orthotic devices.

What Does Health Care Cost  the U.S. Now?

Statements her are largely based upon the Centers for Medicare and Medicaid Services (CMS) a part of the Department of Health & Human Services.

The total annual amount is thought to be:

$3,500,000,000,000  in 32017

$5,700,000,000,000  expected cost in 2026.

$45,000,000,000,000  Expected cost over the next 10 year period.

This amount is paid as follows:

28% by families.

28% by the Federal government.

20% by private business

17% by other governmental agencies.

What  Would Single-Payer Health Care Cost?

$32,600,000,000,000   estimate by the Mercatus Center over the next 10 years.  This estimate is based upon an assumed cost savings of $1,600,000,000,000 saving in administrative costs, plus a $846,000,000,000  savings in drug prices, plus a $5,3000,000,000,000 savings in lower payments to clinical providers.  Many would question these savings.

$5,100,000l,000,000  estimated savings by CMS.

$4,960,000,000,000 estimated savings under Medicare for All due to lower monies paid to clinical providers.

$5,400,000,000,000 estimated cost under Medicare for all, if payments to clinical providers were not reduced.

Concerns:

·          How would the increased taxes required by some plans be spread out among those who paid the taxes?

·         Some $70,000 people would lose their employment, under some plans.

·         Under some proposals, it is likely that there would be very little lowering of the total cost of providing clinical care.

·         The actual issue here may be to what extent should every person be provided all of their needed clinical care.

 

 

 

End of my Post

 

 

 

[8thdaypriest]

Wouldn't be FREE.  Taxes would triple - or more. 

They would keep co-pays, as is the case now with Medicare, because the co-pays limit excessive visits. Would save the gov. money.

Wouldn't just be government paid - would be government CONTROLLED -  everything from the design of hospital rooms to the type of toilet paper used.  Visit a VA hospital to see the style/quality of things. 

Wouldn't be able to choose healthcare provider.   All would have to see the provider they were assigned to.  

Healthcare providers and personnel would not need to please their "customers" - no competition factor.  Services would just be acceptable.

Pharmaceutical companies would stop researching new drugs.  No money to be made.

Bright students would not go into medicine.  No money in it.  Doctors from other countries would flood in.  They would not mind lower income.

Two tier system might emerge - if private insurance, or private pay was still allowed.  Those who could afford it, would pay for the "better" healthcare. 

Then a battle would ensue.  Those on government paid healthcare, would complain they were entitled to the "better" healthcare. 

FREE MARKET COMPETITION and capitalism lower prices - not government control and funding.  Government grows bigger and bigger and bigger - with costs higher and higher and higher - to be paid by YOU - the taxpayer.  Why would we think government healthcare would be any different? 

[8thdaypriest]

Wonder if law suits could no longer be brought - because one would be suing the government?

[8thdaypriest]

Go to a government hospital or clinic.  See how long the wait is. 

Then go to a private hospital or clinic.  MUCH shorter wait.

Just ask the VETS.

Everyone wants the same great healthcare services, but they want the government to pay for them. 

Can't happen. 

[Dr. Shane]

On 10/26/2018 at 12:45 PM, Gregory Matthews said:

This amount is paid as follows:

28% by families.

28% by the Federal government.

20% by private business

17% by other governmental agencies. 

While I am in favor of universal healthcare, according to my civic's teacher, the federal government doesn't have any money.  They have to tax or borrow in order to get money.  So if they will pay for 28% of something, the question is, who will they tax of borrow money from to get that 28%.

[Gregory Matthews]

The above listing is believed to be the present situation.  IOW, it is saying that the Federal Government presently pays 28% of the cost of the nations health care.  That already comes from tax revenue.

 

[8thdaypriest]

In the US, we currently have a "mixed economy".  Some things are government controlled, and some are privately owned and run.  

Many things are government "regulated".  The regulations may set limits on the way company services are offered, or require certain specifications be met for products that are sold. companies are run).

Public utilities are government regulated, but not government run. 

National parks are government owned and run, but also draw some of the money for their support from fees charged to visitors.  

Education is mostly state government run.  Salaries for teachers are low.  Pension benefits WERE good, but now are in doubt due to borrowing from them, and outright embezzling, and unwise investment of the funds. 

The argument for school vouchers has come fully into focus, as parents - wanting better schools for their children - demand some compensation when they take their children out of the public system (for which they pay taxes) and send them to private (for profit) schools, which they believe provide a better educational experience. 

There are local fire rescue departments - run by local governments, and there are state run fire/rescue departments.  Quality of their services depends largely on the tax base paying for their support. 

In recent years states and the nation have assigned security, running of prisons, fire/rescue departments -  to private companies who then charge states (or the nation) for services.   This is known as privatizing.  The state is not then stuck with large pension obligation.

Military hospitals are government owned and run - (unless they have been privatized).  

There are some state hospitals.  Most have been privatized. 

 

 

[8thdaypriest]

If the US government took over all payment for healthcare services:

Everyone would have the SAME INSURANCE - government insurance.  

All OTHER insurance payment plans would cease -  Medicare for seniors, Medicaid, railroad, Tricare for military, Blue Cross, United, Humana, Cigna, Aetna, etc. etc. etc. etc. 

Government insurance would PAY VERY LITTLE for services  (This would result in POOR SERVICE. There would be NO INCENTIVE for doctors, clinics, hospitals to offer better services. Waits would be long.  Services would be limited to those approved by government for each diagnosis.  Pharmaceuticals would be limited to those approved for the government lists.  No new drugs would be developed.  No new medical devices would be researched or developed.  The government would not pay enough to make the development worth it.) 

Government insurance would have a MONOPOLY.

Yes - everyone would get healthcare.   But what kind of healthcare?   LOWER QUALITY Healthcare. 

This is what happens with SOCIALIZED MEDICINE.

SOCIALISM always results in LESS  - FOR EVERYONE. 

Yes.  It serves everyone.  But everyone gets lower quality and less service. 

Is this really what you want?  Is this what you want for United States medicine?

Is this what you want for the United States government?  LESS and LESS and LESS - for everyone.

[8thdaypriest]

IF private insurance companies were allowed to exist - along  with the government socialized system - THEN private companies would continue to develop new drugs and new medical devices.  Also hospitals would compete for patients - thus improving services. 

The problem would be cost.  If citizens were already paying much higher taxes (Canadians pay around 60% of their salaries) there would be little money left to pay for supplemental private health insurance.   A man earning $6000 per month, would be left with $2400 take home.  Not much for a family of 5.  I know such a man.  He works as a prison guard.  His wife has to work, just to make ends meet. 

[8thdaypriest]

The election going on in the USA right now is basically to decide whether the country will go more socialist (government controlled), or go more capitalist (private controlled). 

Around 60% of Dems are socialist.  The whole Medicare for all - is socialist.  A few Dems are radical socialist, and want to use force to collapse the capitalist system.  They also want global socialism - without borders.

The Repubs are capitalist.  Donald Trump is thoroughly capitalist.   He would privatize almost everything. 

The Dems believe socialism will HELP more people.  It will.

The Repubs believe socialism will result in less and fewer things for more people.  It will. 

Some Repubs believe socialism will collapse the economy.  Some Dems believe capitalism will collapse the economy.

So that's the contest.  Don't know who will win - this time anyway. 

We - as believers waiting for the Glorious Return - just want to win souls for Christ - in the time remaining. 

When some call "the other side" EVIL, thus giving folks liberty to harass them - this give me shivers.  Someday WE - believers and servants of Christ who keep His commandments - will be called EVIL by those who seek to silence our testimony. 

Today we see movie stars and the mass media empires daily and hourly teaching that those who disagree with their message are EVIL.   Someday - those empires will coordinate their message AGAINST US - those who "keep the commandments of God and have the faith of Jesus".    Watching what is transpiring today, gives one a vision of what will happen one day soon. 

 

[bonnie]

2 hours ago, 8thdaypriest said:

I

Yes - everyone would get healthcare.   But what kind of healthcare?   LOWER QUALITY Healthcare. 

This is what happens with SOCIALIZED MEDICINE.

SOCIALISM always results in LESS  - FOR EVERYONE. 

Yes.  It serves everyone.  But everyone gets lower quality and less service. 

Is this really what you want?  Is this what you want for United States medicine?

Is this what you want for the United States government?  LESS and LESS and LESS - for everyone.

 

My husband has multiple health issues that. He is 78 years old , still basically functions reasonablly well for the most part. At his age and on SS he is not that productive as far as society goes.  Does not contribute nearly as much as he receives. In strictly monetary terms he takes much more than he returns

Under a one payer government run system what kind of care could we expect. 

1. He has a aortic aneurysm that measures a little over 5cm. Needs to be monitored closely as they would like to repair but unless it is a either or immediate situation will not because of other health issues. Requires MRI twice a year.  I can go directly to cardiologist and have apt and be seen in a timely manner without my GP

2. COPD which is slowly but surely progressing. Nurse  comes to home monitor situation, paid for by insurance.

3.Atrial fibrillation which needs to be treated

4.Has had five strokes, partially due to the Afib and compounded by hole in heart.

5. Medicare and supplemental insurance pay all. Requires monthly Dr. visits.

6. Knee and hip replacement for myself was done in a very timely fashion. No long waits, no needing the GP first. First visit went immediately and had MRI. What would it be with one payer ?

7. Sudden and very intense carpel tunnel in both hands. Dr. visit and surgery was within days. What would it be on socialized medicine?

[phkrause]

3 hours ago, bonnie said:

What would it be with one payer ?

I guess we'll never know?? But with competition you'd think prices would get lower?

3 hours ago, bonnie said:

What would it be on socialized medicine?

Other Countries have this and do all right??

Every system has its problems?

[bonnie]

20 minutes ago, phkrause said:

I guess we'll never know?? But with competition you'd think prices would get lower?

Other Countries have this and do all right??

Every system has its problems?

I guess it depends on what you consider "doing all right". Prior to my first replacement surgery a online friend in Australia had a similar problem. She was on a waiting list that could have been up to four years. She could not afford private insurance. That to me is not doing alright. I began having problems several months after she was placed on waiting list and had replacement surgery within days of diagnosis. I had insurance, but an acquaintance on Medicaid was treated as quickly as I was. Cataract surgery was as prompt instead of months.  Had I had to wait the many months for carpel tunnel surgery the damage to my left hand would have been permanent as is true for the relative of a friend of mine in Canada. 

That is not doing alright in my book. Doing alright might mean that my husband would have to wait months for medical diagnosis and treatment. He might not have the months to wait.

[phkrause]

58 minutes ago, bonnie said:

I guess it depends on what you consider "doing all right". Prior to my first replacement surgery a online friend in Australia had a similar problem. She was on a waiting list that could have been up to four years. She could not afford private insurance. That to me is not doing alright. I began having problems several months after she was placed on waiting list and had replacement surgery within days of diagnosis. I had insurance, but an acquaintance on Medicaid was treated as quickly as I was. Cataract surgery was as prompt instead of months.  Had I had to wait the many months for carpel tunnel surgery the damage to my left hand would have been permanent as is true for the relative of a friend of mine in Canada. 

That is not doing alright in my book. Doing alright might mean that my husband would have to wait months for medical diagnosis and treatment. He might not have the months to wait.

Well my Mom had knee surgery a number of years ago and from start to finish it took about 3/4 months or so!! My Mom's sister had the same surgery in Germany and from start to finish it took about 1 week and didn't pay a dime!! Not sure what my Mom payed, and I can't ask her anymore since she passed away a few months ago, but I'm pretty sure she paid a good amount!