Healthcare

[berbatrick]

Got more of these?

A slightly older poll, by a different polling agency.

Trend over time, from yet another polling agency.

Who among the democratic candidates are openly supporting this? And who among the republicans are not openly against it?

Bernie has it at the centre of his campaign, others support it on paper but say it is too drastic in practice. Not Republican politician will support it.

I think there's enough data showing that it's a viable idea among the public. And that it is hideously unpopular among politicians (up until 2016, Bernie was literally the only one supporting it even on paper).

I'll let you figure out why - I think the only information you need to know is that the insurance industry revenue was just shy of $1 trillion (trending upwards) last year, hospital revenue was in the same order range, there was additional govt spending of about half the amount, and the pharma industry earned about half its global revenue in the US.

 

[Fosu-Mens]

A slightly older poll, by a different polling agency.

Trend over time, from yet another polling agency.

Bernie has it at the centre of his campaign, others support it on paper but say it is too drastic in practice. Not Republican politician will support it.

I think there's enough data showing that it's a viable idea among the public. And that it is hideously unpopular among politicians (up until 2016, Bernie was literally the only one supporting it even on paper).

I'll let you figure out why - I think the only information you need to know is that the insurance industry revenue was just shy of $1 trillion (trending upwards) last year, hospital revenue was in the same order range, there was additional govt spending of about half the amount, and the pharma industry earned about half its global revenue in the US.

Good to see the public opinion is going towards it.

Is Bernie still the only one publicy for it? Rest of them are sitting on the fence?

Politicans don't want it because of endorsement from these industries. And because it is socialism?

 

[berbatrick]

Good to see the public opinion is going towards it.

Is Bernie still the only one publicy for it? Rest of them are sitting on the fence?

Politicans don't want it because of endorsement from these industries. And because it is socialism?

The others say they want a more gradual path towards it, for which there is also political support. I don't think Warren is taking their money, so for her it may be something she believes is better. I don't know if the gradual path thing works - Medicare was introduced in the 60s* and hasn't been substantially expanded since.
For Pete and especially Biden, they take industry money.
https://www.vox.com/2019/4/26/18515699/joe-biden-2020-presidential-campaign-medicare-for-all
It could be the fear of being smeared as socialists, but they're fools if they think their plans won't also be smeared.

*I googled medicare and these were the top 3 headlines - I forgot to add that large parts of the media hate it as well.

 

[Fosu-Mens]

The others say they want a more gradual path towards it, for which there is also political support. I don't think Warren is taking their money, so for her it may be something she believes is better. I don't know if the gradual path thing works - Medicare was introduced in the 60s* and hasn't been substantially expanded since.
For Pete and especially Biden, they take industry money.
https://www.vox.com/2019/4/26/18515699/joe-biden-2020-presidential-campaign-medicare-for-all
It could be the fear of being smeared as socialists, but they're fools if they think their plans won't also be smeared.

*I googled medicare and these were the top 3 headlines - I forgot to add that large parts of the media hate it as well.

Not a fan of the gradual shift. For healtcare for all to work one needs to make radical changes. Personally i think the best long term outcome for the average american, in regards to healtcare and financial cost, is closer to how Saunders wants it. Do it immediatly(preferably prototyping the shift in a couple of states).

People can argue that the economies of scale rule does not apply to the states because "we are larger than the european countries" and "we are so different", but the same arguement can be made the other way. They are as big and diverse that doing this on a large scale would be even more financially beneficial to the country.

For it to work fully in the states, some changes and regulations needs to happen:
- digitalization of the paperwork and the systems in different departments and hospitals needs to be able to "talk" together. Best would be to have the files in a national "bank" where everything could be pulled from. And having standardized patientfiles that everyone understands and can be transfered to every hospital.
- Regulation of pricing/deprivatization of hospitals and and the big pharma industry.
- Private insurance --> To bad. Regulate the "profit" margins and policies they can have and offer.
- Stop with the overdiagnozing and overtesting. Do not need to take CT/MR/Xnumb of bloodtests if you are feeling dizzy or fell of your bike.

Medicare for all would cause maybe 10% of the american population to have worse healthcare, given they excellent insurance. But the rest of the country would get better healtcare possibilities. Wheras today the situation is closer to the opposite.

 

[Raoul]

Not a fan of the gradual shift. For healtcare for all to work one needs to make radical changes. Personally i think the best long term outcome for the average american, in regards to healtcare and financial cost, is closer to how Saunders wants it. Do it immediatly(preferably prototyping the shift in a couple of states).

People can argue that the economies of scale rule does not apply to the states because "we are larger than the european countries" and "we are so different", but the same arguement can be made the other way. They are as big and diverse that doing this on a large scale would be even more financially beneficial to the country.

For it to work fully in the states, some changes and regulations needs to happen:
- digitalization of the paperwork and the systems in different departments and hospitals needs to be able to "talk" together. Best would be to have the files in a national "bank" where everything could be pulled from. And having standardized patientfiles that everyone understands and can be transfered to every hospital.
- Regulation of pricing/deprivatization of hospitals and and the big pharma industry.
- Private insurance --> To bad. Regulate the "profit" margins and policies they can have and offer.
- Stop with the overdiagnozing and overtesting. Do not need to take CT/MR/Xnumb of bloodtests if you are feeling dizzy or fell of your bike.

Medicare for all would cause maybe 10% of the american population to have worse healthcare, given they excellent insurance. But the rest of the country would get better healtcare possibilities. Wheras today the situation is closer to the opposite.

The radical changes approach unfortunately wont work in the US because you need the support of Congress for this sort of sweeping law to pass, which won't happen because the Republicans and some Democrats will vote against it. The only approach that is tangibly viable in the present is to do it in two steps, the first being to move half the country (the ones who aren't currently on employer based plans) to government plans and allow people who want to stay on their employer based plans to do so. Once that is in place, you then sweeten the pot for employers to gradually disengage providing private insurance by steepening the costs for them, which will over time force people to move to government plans. Once enough people realize there is no incentive to remain on employer based private insurance plans, the entire country will gradually be on what we currently see as medicare for all. The trouble with the current "all or nothing" medicare for all approach is that it almost certainly won't pass and will leave people with no tangible progress for the next several years. The two step method is far more realistic imo.

 

[Silva]

The problem with the two step method is that you're always two steps behind. The ACA was meant to be the first step and American healthcare has only gotten worse. The same will happen in any other system. It will quickly fall apart and people will again be having the medicare now or medicare later argument.

 

[Raoul]

The problem with the two step method is that you're always two steps behind. The ACA was meant to be the first step and American healthcare has only gotten worse. The same will happen in any other system. It will quickly fall apart and people will again be having the medicare now or medicare later argument.

Yes...the ACA was step 1 of what are actually 3 steps (the remaining two are the ones I mentioned above). The difference between now and a decade ago when the ACA was being implemented is premiums are quickly spiralling out of control because the Republicans have been gradually eroding the individual mandate and other provisions to discredit the law, which is creating the conditions for the need for another step in the process, which will imo be moving anyone in the country who wants to be on medicare on a government plan. Anything short of that will imo fail and the public will be left scratching their heads why nothing has changed.

 

[Silva]

Yes...the ACA was step 1 of what are actually 3 steps (the remaining two are the ones I mentioned above). The difference between now and a decade ago when the ACA was being implemented is premiums are quickly spiralling out of control because the Republicans have been gradually eroding the individual mandate and other provisions to discredit the law, which is creating the conditions for the need for another step in the process, which will imo be moving anyone in the country who wants to be on medicare on a government plan. Anything short of that will imo fail and the public will be left scratching their heads why nothing has changed.

That will happen again and again until there is universal healthcare. A rest bite is passed. It quickly gets dismantled and broken. Another one is passed and is quickly dismantled and broken. You can't rely on good faith from what is a fundamentally broken and corrupt political system where helping the upper classes results in politicians being rewarded.

 

[Fosu-Mens]

The radical changes approach unfortunately wont work in the US because you need the support of Congress for this sort of sweeping law to pass, which won't happen because the Republicans and some Democrats will vote against it. The only approach that is tangibly viable in the present is to do it in two steps, the first being to move half the country (the ones who aren't currently on employer based plans) to government plans and allow people who want to stay on their employer based plans to do so. Once that is in place, you then sweeten the pot for employers to gradually disengage providing private insurance by steepening the costs for them, which will over time force people to move to government plans. Once enough people realize there is no incentive to remain on employer based private insurance plans, the entire country will gradually be on what we currently see as medicare for all. The trouble with the current "all or nothing" medicare for all approach is that it almost certainly won't pass and will leave people with no tangible progress for the next several years. The two step method is far more realistic imo.

True, but the two step/gradual approach problem is the total cost and time. During the transitionphase it will be chaos. The financial benefits in a "health care for all" solution are best seen when everyone got it, and the healtcare system implements the economic of scale related solutions --> standardizations, big bulk... Same as for why Wallmart and Tesco are so profitable.

Problem when you have a congress where they think about what is best for their financial contributors and what the media say, rather than what would be best long term for your average citizen (this is a problem in all democratic Countries to be honest).

 

[Eboue]

Yes...the ACA was step 1 of what are actually 3 steps (the remaining two are the ones I mentioned above). The difference between now and a decade ago when the ACA was being implemented is premiums are quickly spiralling out of control because the Republicans have been gradually eroding the individual mandate and other provisions to discredit the law, which is creating the conditions for the need for another step in the process, which will imo be moving anyone in the country who wants to be on medicare on a government plan. Anything short of that will imo fail and the public will be left scratching their heads why nothing has changed.

Premiums were spiraling massively while Obama was still in office. The ACA is garbage.

 

[Rob]

Anyone who doesnt support Medicare for All is complicit. The human suffering is staggering.

Staggering. From the outside it seems so many Americans are completely brain washed when it comes to UHC. With their freedom and deep state and all. I mentioned it in this thread a while back, but there was this story with a man who suffered from black lung and was dependant on ACA as he wouldn’t be able to pay for the medicine otherwise. He voted for Trump anyway. For the life of me, I can’t fathom how a dem candidate isn’t sweeping the floor with a slogan that says that no one should die if they because they’re poor or go bankrupt if uninsured. How the feck can you feel strongly enough about any other subject to not vote for that.

 

[Snowjoe]

Anyone who doesnt support Medicare for All is complicit. The human suffering is staggering.

But. But. State sponsored socialist death panels or something right?

My 80 year old grandad recently had some bowel removed to remove cancer. Got an infection and was on the verge of death. He spent 2 weeks in intensive care with his own personal nurse at all times, before being moved to another ward and then into respite care for 2 more weeks as a stepping stone from hospital to home. He probably hasn’t come close to paying for that in taxes in his entire life. But taxes are theft or against freedom or some shit. I’d pay even more tax honestly.

I’d hate for him to have had that in America and now have to spend his life worrying about money rather than when he’s finally going to be allowed a pint of Guinness.

 

[mav_9me]

But. But. State sponsored socialist death panels or something right?

My 80 year old grandad recently had some bowel removed to remove cancer. Got an infection and was on the verge of death. He spent 2 weeks in intensive care with his own personal nurse at all times, before being moved to another ward and then into respite care for 2 more weeks as a stepping stone from hospital to home. He probably hasn’t come close to paying for that in taxes in his entire life. But taxes are theft or against freedom or some shit. I’d pay even more tax honestly.

I’d hate for him to have had that in America and now have to spend his life worrying about money rather than when he’s finally going to be allowed a pint of Guinness.

Where is this?

 

[Snowjoe]

Where is this?

England

 

[Red Defence]

Anyone who doesnt support Medicare for All is complicit. The human suffering is staggering.

Absolutely.

I don’t know why I came into this thread, I rarely do because it’s the most heart-breaking thread on the forum. I”m sat here now completely filling up as I read these tweets because I’d have been dead years ago if I lived in the US and had to pay for this treatment you call health care. I’m just so fortunate that I don’t live there. I’ve worked in hospitals all my life and I can say without doubt that many, many people that were treated there would never have been able to have treatment in the US and most of them would have died at an early age. People I knew and people I didn’t know. Some were friends and some were family.

My god America it’s time you moved to a system where all can be treated, whether they have money or not. To cause pain and cruelty to anyone is bad enough but to deliberately cause it to your own countrymen, your own neighbours and your own family and friends is utterly shameful and abhorrent.

Oh...and I’m in England too.

 

[Billy Blaggs]

The irony is that they all get free Healthcare.

fecking hypocrites!

 

[nimic]

The irony is that they all get free Healthcare.

fecking hypocrites!

What do you mean?

Members of Congress?

 

[Billy Blaggs]

What do you mean?

Members of Congress?

Yep

 

[Eboue]

 

[Red Dreams]

Greatest Country in the world.

 

[Eboue]

these stories are the best way to radicalize people. Risk pools and administrative savings arent convincing to normal people.

 

[oneniltothearsenal]

And of course we get some really, really bad decision making theories from corporate shills

"Even then there were red flags: As far back as the 1970s, a landmark study by the California-based Rand Corp. had found that requiring people to pay more out of pocket caused them to cut back on medical care they needed as well as on unnecessary services.

Backers of the high-deductible strategy nevertheless argued that patients, given “skin in the game,” would become active consumers who would force drugmakers, hospitals and other medical providers to rein in prices.

“The thing that caught people’s imagination was this idea of unleashing American patients as consumers,” said Dr. Arnie Milstein, medical director of the California-based Pacific Business Group on Health, an organization of large companies, including Boeing, Safeway, Walmart and Wells Fargo.

Employers, desperate for a way to control healthcare spending, saw an opportunity to hold down costs"


https://www.latimes.com/politics/la-na-pol-health-insurance-medical-bills-20190502-story.html

 

[utdalltheway]

Was just looking at my weekly paycheck and noticed that my gross/net looked a little low. It turns out I'm paying 37% of my gross salary in deductions.

None of those deductions are for a pension, or dental care - just regular deductions such as federal tax, state tax, soc security, medicare (that's a fcukin laugh!)....

So, a question: how does that compare to folks in Europe/Canada/Oz on a % basis? You get subsidized (or free) university, almost free healthcare, etc?

 

[Snowjoe]

Was just looking at my weekly paycheck and noticed that my gross/net looked a little low. It turns out I'm paying 37% of my gross salary in deductions.

None of those deductions are for a pension, or dental care - just regular deductions such as federal tax, state tax, soc security, medicare (that's a fcukin laugh!)....

So, a question: how does that compare to folks in Europe/Canada/Oz on a % basis? You get subsidized (or free) university, almost free healthcare, etc?

You generally have to be earning a decent wage to lose that much in tax & national insurance contributions in the UK. Most people wouldn’t come close

 

[Red Viking]

Was just looking at my weekly paycheck and noticed that my gross/net looked a little low. It turns out I'm paying 37% of my gross salary in deductions.

None of those deductions are for a pension, or dental care - just regular deductions such as federal tax, state tax, soc security, medicare (that's a fcukin laugh!)....

So, a question: how does that compare to folks in Europe/Canada/Oz on a % basis? You get subsidized (or free) university, almost free healthcare, etc?

Most Danes pay around 37% in income tax and that includes tax paid health care ( + much cheaper medicine than in the US ) and free to use education on all levels starting from regular school to university.

 

[George Owen]

Most Danes pay around 37% in income tax and that includes tax paid health care ( + much cheaper medicine than in the US ) and free to use education on all levels starting from regular school to university.

I would gladly pay that or more, if that guarantee education and healthcare of the same high standards for all the population.

 

[Red Viking]

I would gladly pay that or more, if that guarantee education and healthcare of the same high standards for all the population.

It is a great price to pay as it guarantee the most basic things that a person need to succeed in life if they want to put in the effort + it increases social mobility and helps people with the best natural ability to move up the social ladder and this is good for society in general. A state need the best and most talented people it has to succeed and this is essential in a world where competition is ever increasing through globalization. Just see what a lack of social mobility in America has done to the top of the society there partly due to lack of investment in the ordinary person through the state.

The minimum wage in Denmark is also much higher compared to the US. It is at least around 120+ Danish Kroner per hour in 90% of all industries as a starting wage ( roughly 18 dollars a US atm ) and we can thank strong union work for that. It is a complete myth that high minimum wages is bad for an developed economy. It is actually very important economic policy that helps keep demand for goods and services relatively high even amongst the lowest paid members of society ( it keeps the economy stimulated to sufficient levels most of the time and this help stabilize the economy with less dramatic economic downturns like in the USA ).

 

[berbatrick]

I'm not extroverted at all but one of the 2 Trump supporters I have talked to was quite satisfied with the argument that for the 40% UK taxes, they got their healthcare taken care of. (He also wanted the US to withdraw from Af/Pak/Middle East generally, and "the money must be spent at home").

 

[utdalltheway]

That's the myth I'm testing; the 40% tax rate.

For arguments sake, say I make approx Euros 80k-100k/p.a. - what would be my % deductions over there?

 

[Red Viking]

That's the myth I'm testing; the 40% tax rate.

For arguments sake, say I make approx Euros 80k-100k/p.a. - what would be my % deductions over there?

You´d pay about 185.065 DK in income tax in total here with income at 80.000 Euro a year here. 80.000 Euro is roughly 600.000 DK a year. This depend a bit other factors as well so it is a rough estimate. This leaves 415.000 DK. We have a 46.000 tax free amount every year per person for everyone.

Your income tax deduction would be at 37%.

 

[berbatrick]

 

[utdalltheway]

So for the same tax rate I could be getting free healthcare and uni? Instead of cruise missiles and almost constant war?
Kinell!

 

[Eriku]

Was just looking at my weekly paycheck and noticed that my gross/net looked a little low. It turns out I'm paying 37% of my gross salary in deductions.

None of those deductions are for a pension, or dental care - just regular deductions such as federal tax, state tax, soc security, medicare (that's a fcukin laugh!)....

So, a question: how does that compare to folks in Europe/Canada/Oz on a % basis? You get subsidized (or free) university, almost free healthcare, etc?

Already been answered but for my part I pay 36% of my wage in taxes, and in Norway you have to pay a deductible, but it’s capped at about 250 dollars a year. That goes for GP visits, any scans or tests, psychiatric help, anything that’s not frivolous, like a boob job. Does not cover dental, though.

If I want to study, I would have to pay a bit under 100 dollars a semester to attend a public University, and pay for books and equipment.

If I need an ambulance I can make the call, it’s covered, be it helicopter or on wheels.

 

[Siorac]

Was just looking at my weekly paycheck and noticed that my gross/net looked a little low. It turns out I'm paying 37% of my gross salary in deductions.

None of those deductions are for a pension, or dental care - just regular deductions such as federal tax, state tax, soc security, medicare (that's a fcukin laugh!)....

So, a question: how does that compare to folks in Europe/Canada/Oz on a % basis? You get subsidized (or free) university, almost free healthcare, etc?

I pay 34% of my gross salary in taxes. That includes pension, health care and income tax. I get 24 days off a year and will get more as I get older and if I have kids. Higher education is completely free; that is, there is no tuition fee at all. If I'm unhappy with the state-run healthcare, I can opt for private care which is still far, far cheaper than the US. A root canal, for example, cost me around €150.

This is in shitty ex-communist, corrupt, brain drained Hungary.

 

[Snow]

So for the same tax rate I could be getting free healthcare and uni? Instead of cruise missiles and almost constant war?
Kinell!

Basically, it's not completely free here in Iceland. Tuition in college is about $600 a year but you can pay for about 80% that out a union fund. There's also a nominal fee for a doctors visit and I think it's capped at something like $160 and $1600 per year that you have to pay in total medical bills if you are really sick.
For example I had to take my gall bladder out this year. I went to emergency room for pains where it was discovered. I was sent to a specialist to X-ray me and then I had to see a gastrointestinal surgeon who's job it was to assess if I needed surgery and how urgent it was. He put me on the waiting list and a month later I had surgery. The surgery was actually the cheapest of the whole process and that dad I had several nurses and doctors taking care of me. It cost me about the $160 fee in total. So similar to what Eriku told you about Norway but not as cheap as we don't have all that oil money that Norway does (their stuff could actually be cheaper those tight bastards).

 

[jojojo]

That's the myth I'm testing; the 40% tax rate.

For arguments sake, say I make approx Euros 80k-100k/p.a. - what would be my % deductions over there?

Based on a single person tax allowance, in the UK a salary of £90k (that's about 105k euros), would mean a take home pay of around £60k, after deducting National Insurance and tax. Personally I think that tax rate needs to go up by a few points to improve the services it covers. But no, it's not 40% of total salary - you'd need to be on over £250k for that.

Pension contributions (beyond the basic state pension covered by NI) are an extra cost, though they are tax deductible so higher earners use them as a kind of tax free saving.

 

[Danny_]

Medicare for all (our version of govt healthcare) won't happen due to the political barriers which are a huge mountain to overcome. I am a proponent of it even though it might cost me my job if it ever happens. It's wrong what happens to people over here and I want to see the abuses of the current system stop. Here is why:

1) Most people pay around $200 a month for an individual insurance policy and their employer pays the rest. What people often do not realize is that 'the rest' is on average 82 percent of the cost of the premium. What is so insidious about the current system is that if you lose your job, your employer stops paying. So, all of a sudden, at the time you are most vulnerable, your healthcare policy goes from costing you $200 a month to $1000 per month. You have no job and you now also probably have no healthcare, or a thrash healthcare policy that you are forced to buy since Obamacare made it mandatory for everyone to have a healthcare policy. Even if you are not unlucky and don't lose your job, you have to live with the fear of this hanging over you.

2) People often point to the cost to the govt of Healthcare. Currently, Medicare is for people over the age of 65. You cannot enroll in it until you are 65 years old. The two exceptions to this are if you are disabled or if you have end stage renal disease and are on dialysis or have had to have a kidney transplant. That is a very small amount of people though so it is mostly just for seniors. The cost of the program is currently around $600 billion per year. That is about 14.3 percent of total govt expenditure. It is projected to double in the next 20 years due to the baby boomers retiring. So, just catering to seniors, within 20 years, it will cost almost 30 percent of total govt expenditure. How can we afford to include everyone in this program is what people on the right will say and they do have a point.

However, they are generally overlooking two facts. 1. Almost everyone currently in the program is a high risk member since you generally need more healthcare services, the older you get. Obvioulsy, this means that if you include people from 18-65 in it, you get healthy people who are paying the medicare part B premium of around $230 per month and who will not use it much. So, it's difficult to come up with a good estimate on how much it will cost to include all of these new people.

2. If we transfer responsibility from the employers to cover healthcare to a govt program like Medicare, that will be a massive cost off American company's books and we could make them pay a medicare tax in order to try to offset any shortfall in govt funds to pay for the new single payer system. Some companies (those that don't work in healthcare) would probably be very happy to do this as it will still cost them less.

There are other reasons other than these two that I won't get into but these are the two main points in favor of making the change. I wish it were possible but I am a realist so I know it won't happen, not at least until there is a tsunami of public opinion in favor or making the change. But, I really do hate the system we currently have. It's so unfair on so many people.

 

[Adisa]

My sister who's doing a PhD and also working for Auburn University is planning on moving to Canada just for this single issue. I

 

[Snowjoe]

1) Most people pay around $200 a month for an individual insurance policy and their employer pays the rest. What people often do not realize is that 'the rest' is on average 82 percent of the cost of the premium. What is so insidious about the current system is that if you lose your job, your employer stops paying. So, all of a sudden, at the time you are most vulnerable, your healthcare policy goes from costing you $200 a month to $1000 per month. You have no job and you now also probably have no healthcare, or a thrash healthcare policy that you are forced to buy since Obamacare made it mandatory for everyone to have a healthcare policy. Even if you are not unlucky and don't lose your job, you have to live with the fear of this hanging over you.

It’s even more laughable considering the amount of country with at-will employment.

 

[freeurmind]