U.S. Healthcare

[Ten oz]

26 minutes ago, iNow said:

GOP opposition to healthcare strikes me as pathological at this point, especially given the plan they're attacking is itself a watered down version of one authored by conservatives.

Polling for individual portions of the ACA like pre-existing conditions and medicare expansion are extremely popular across all demographics and party affiliation. The hangover from the faux Obamacare outrage looms over this process. Everyone likes the ACA but people on the right hate Obamacare. 

 

***Disclaimer - I am aware Obamacare is a nic name for the ACA.

Edited March 28, 2019 by Ten oz

[beecee]

On 3/28/2017 at 7:19 AM, Ten oz said:

How do we pay for it?

Coming into this late, but why not simply a 1.5% or similar levy on all wages and salaries? Is that really so hard or difficult for Americans to accept? I mean it works in other countries. 

[Ten oz]

8 minutes ago, beecee said:

Coming into this late, but why not simply a 1.5% or similar levy on all wages and salaries? Is that really so hard or difficult for Americans to accept? I mean it works in other countries. 

In theory it would be that easy, yes. However we (U.S.) currently run an annual deficit of over a trillion dollars a year. We can't afford the current spending levels we have with our current level of Taxation. 

Also while it does work elsewhere it has also been in place in many areas since the end of WW2 when nations were rebuilding. Here in the U.S. private healthcare spending is over $3 trillion a year and accounts for 18% of GDP. It never should have gotten to this point but is at it all the same. Folding a $3 trillion dollar a year industry into a singular govt overseen program will impact jobs, 401k's, and etc. In time I believe it can be done. However I don't believe the way forward is obvious or simple. 

[beecee]

32 minutes ago, Ten oz said:

In theory it would be that easy, yes. However we (U.S.) currently run an annual deficit of over a trillion dollars a year. We can't afford the current spending levels we have with our current level of Taxation. 

Also while it does work elsewhere it has also been in place in many areas since the end of WW2 when nations were rebuilding. Here in the U.S. private healthcare spending is over $3 trillion a year and accounts for 18% of GDP. It never should have gotten to this point but is at it all the same. Folding a $3 trillion dollar a year industry into a singular govt overseen program will impact jobs, 401k's, and etc. In time I believe it can be done. However I don't believe the way forward is obvious or simple. 

Australia also has a debt/deficit, and I would say the same applies to many countries.

The levy system in Australia is a two tier system, 1.5% for most wage earners, and those above a certain amount, pay a 1% surcharge. The two tier health levy system is also backed and supported by private health insurance if one so chooses,, which covers such things as gaps, private ward in hospital, and a Teddy bear in bed with you. 

The system covers doctors visits, stays in hospital, Operations [other then cosmetic surgery] X-Rays and such, most prescriptions at a fixed subsidized price with a ceiling limitation after which it is free, some home care for retired seniors, eg: My Mother had her unit fixed out with safety rails in the toilet and bathroom, and other home services as prescribed by a doctor, eg; A mate of mine spent a month in hospital with a Staph infection, then a month at home with daily visitations from a nurse to change his continued anti-biotic treatment. All without personal cost and all without private health insurance.

Edited March 28, 2019 by beecee

[John Cuthber]

1 hour ago, Ten oz said:

In theory it would be that easy, yes. However we (U.S.) currently run an annual deficit of over a trillion dollars a year. We can't afford the current spending levels we have with our current level of Taxation. 

Yes, but you can change taxes.
US healthcare expenditure is roughly twice that of most Western countries (without a noticeably better set of outcomes).
So you just have to set up a "market" in health provision.

People can choose to pay $ X ot their current provider or $ X/2 as tax for nationalised healthcare.

The sane people will choose to pay the extra tax, because they end up paying less.

All you need to do is tell them that they are actually paying some big multinational company, rather than paying a tax.

Here in the UK we have a National Health Service that is (or at least was) widely envied.
We also have a spending deficit. 
But the government is trying to blame the cost of the NHS for the deficit.

In fact they are responsible for it.
They have doubled the national debt in the last 10 years or so.
They also make a habit of pretending to be the party of sound financial management.
What they have done is cut taxes and privatise  state run services.
 

This ends up costing a lot more- not least because they sometimes end up paying twice because the company they pay manages to lose the money - so the  govt bails out the rich business owners.

 

 

 

 

Edited March 28, 2019 by John Cuthber

[Ten oz]

34 minutes ago, beecee said:

Australia also has a debt/deficit, and I would say the same applies to many countries.

The levy system in Australia is a two tier system, 1.5% for most wage earners, and those above a certain amount, pay a 1% surcharge. The two tier health levy system is also backed and supported by private health insurance if one so chooses,, which covers such things as gaps, private ward in hospital, and a Teddy bear in bed with you. 

The system covers doctors visits, stays in hospital, Operations [other then cosmetic surgery] X-Rays and such, most prescriptions at a fixed subsidized price with a ceiling limitation after which it is free, some home care for retired seniors, eg: My Mother had her unit fixed out with safety rails in the toilet and bathroom, and other home services as prescribed by a doctor, eg; A mate of mine spent a month in hospital with a Staph infection, then a month at home with daily visitations from a nurse to change his continued anti-biotic treatment. All without personal cost and all without private health insurance.

Yes but the other piece, private Healthcare being 18% of GDP, doesn't get addresses. We can raise taxes by a couple percentage points and still bring in less overall revenue if GDP declines. A couple percentage point increase in taxation can fill the gap for 18% of GDP. Profits and payrolls must be reduced which would reduce tax revenue. 

$3 trillion wouldn't be raised by a 2% tax. Rather the govt would need to control costs and make it more affordable. That is good and needs to happen but will reduce the amount of money presently changing hand in the industry and reduce tax revenue over all as a result for several years until the industry finds equilibrium. The result could mean several trillion dollars of new debt. 

8 minutes ago, John Cuthber said:

Yes, but you can change taxes.

Changing taxes might not increase revenue if GDP slumps as a result of the change. 

26 minutes ago, John Cuthber said:

healthcare expenditure is roughly twice that of most Western countries (without a noticeably better set of outcomes).
So you just have to set up a "market" in health provision.

Sadly here in the States the outcome the Healthcare industry cares about is money and not health. From that perspective the outcomes are far better in the States than they are in the U.K.. 

The ACA requirement that everyone have coverage was a good compromise. It promised the industry more paying customers for plans that didn't discriminate against preexisting conditions, we're more affordable, and so on. It improved quality of care and cut costs without causing financial hardships to the industry. 

Morally I think the private healthcare industry here in the states deserves hardship. They behave unethically. That said I don't think it is prudent to take the whole country down with them. 

[Phi for All]

53 minutes ago, John Cuthber said:

Here in the UK we have a National Health Service that is (or at least was) widely envied.
We also have a spending deficit. 
But the government is trying to blame the cost of the NHS for the deficit.

In fact they are responsible for it.
They have doubled the national debt in the last 10 years or so.
They also make a habit of pretending to be the party of sound financial management.
What they have done is cut taxes and privatise  state run services.
 

This ends up costing a lot more- not least because they sometimes end up paying twice because the company they pay manages to lose the money - so the  govt bails out the rich business owners.

I used to think this was partisan behavior, but now I'm pretty sure it's just how extremist capitalism works the political systems. The uber wealthy are always eager to find newer and bigger ways to leech more money away from where it's supposed to go.

[iNow]

This isn't an issue of right and left, it's an issue of right and wrong

[Ten oz]

1 hour ago, Phi for All said:

I used to think this was partisan behavior, but now I'm pretty sure it's just how extremist capitalism works the political systems. The uber wealthy are always eager to find newer and bigger ways to leech more money away from where it's supposed to go.

Boom!!!!

Whether it is climate change, the opioid epidemic, healthcare, or etc no solution can be considered free from how those who will profit will respond. 

[John Cuthber]

On 3/28/2019 at 8:34 PM, Ten oz said:

Sadly here in the States the outcome the Healthcare industry cares about is money and not health.

How did that happen?

On 3/28/2019 at 8:34 PM, Ten oz said:

Changing taxes might not increase revenue if GDP slumps as a result of the change. 

In percentage terms, how big is this change?

[Ten oz]

8 hours ago, John Cuthber said:

How did that happen?

Greed

8 hours ago, John Cuthber said:

In percentage terms, how big is this change?

Total tax revenue brought in by the U.S. Govt in 2018 was $3.3 trillion. If you are asking how much tax revenue was specifically generated by private insurance companies and associated industries like pharmacies or medical  equipment manufactures I do not know the answer to your question. It would require a level of research I have not performed. This link outlines how much is spent per type of service: Dental, Hospice, Nursing, etc Link. It amounts to $3.5 trillion or 18% of national GDP.

The situation is stupid. People have retirement accounts investigated in private insurance, pharmaceutical companies, and etc. I want the country to move towards single payer but believe it must be done in steps overtime. We cannot transform and eliminate spending to a $3.5 trillion dollar a year industry over night. As an industry, in dollars, it is large as the federal Govt itself and employees millions of people.

Quote

 

While about 11 percent of private-sector workers work in health care establishments nationwide, that percentage varies from one metropolitan area to another. In many metropolitan areas—including Duluth, Minnesota-Wisconsin; McAllen-Edinburg-Pharr, Texas; Morgantown, West Virginia; and Brownsville-Harlingen, Texas–the proportion of private-sector workers employed in health care exceeds 20 percent. In large metropolitan areas the number of workers employed in health care may be in the hundreds of thousands, yet the percentage of workers in health care in those areas is closer to the nationwide figure. 

https://www.bls.gov/spotlight/2009/health_care/

 

 

[John Cuthber]

If you move all the doctors and nurses etc who currently work in the private sector into the public sector, does that actually affect GDP?

There are currently sick people who don't get treated.
If they were treated then that would mean there were more medical staff working- which would boost GDP and it would mean that the sick people could (in many instances) get back to work which would also boost GDP.

[Ten oz]

18 minutes ago, John Cuthber said:

If you move all the doctors and nurses etc who currently work in the private sector into the public sector, does that actually affect GDP?

There are currently sick people who don't get treated.
If they were treated then that would mean there were more medical staff working- which would boost GDP and it would mean that the sick people could (in many instances) get back to work which would also boost GDP.

My understanding is that only about a third of the money goes to care.The rest goes to profit and administrative costs. There are a lot of wealthy @##holes cruising around in yachts off the back of our ridiculous system. So even it every Doctor and Nurse were retained at full salary there would be a decline. 

Your point about more people getting care is what the Healthcare mandate in the ACA addresses. Private Insurance companies agreed to expand care in trade for more paying customers. It was a good first step in my opinion. I think the mandate needs be better enforced and and cost control at current levels. All new expansion of coverage should be handled by Medicare. That basically freezes the private healthcare industry where they are without a significant decline in spending and allows the nation to shift over to a single payer program overtime. It isn't bumper striker material though.